Attorney General Bonta Supports Efforts to Vacate Trump Administration Rule Allowing Health Care Discrimination

OAKLAND — California Attorney General Rob Bonta led 19 attorneys general in filing an amicus brief in Boston Alliance of Gay, Lesbian, Bisexual and Transgender Youth (BAGLY), et al. v. United States Department of Health and Human Services (HHS), et al. in support of the plaintiffs’ motion to vacate the Trump Administration’s 2020 federal rule (the Rule), which strips nondiscrimination protections in Section 1557 of the Affordable Care Act (ACA). The plaintiffs, a group of civil rights and reproductive health advocacy organizations, challenged the Rule as arbitrary and capricious and contrary to law under the Administrative Procedure Act (APA), stressing the serious health and social harms that it imposes on underserved populations. In the brief, Attorney General Bonta stresses the importance of upholding the nondiscrimination protections of Section 1557 in ensuring equitable access to health care.

“Section 1557 of the Affordable Care Act was a landmark provision ensuring expanded access to health care, particularly for underserved communities facing significant barriers in our nation’s health care system,” said Attorney General Bonta. “Unfortunately, the practice of discrimination in health care has become overwhelmingly obvious, and has affected so many we call friends, family, and neighbors. Despite the Trump Administration’s efforts to roll back these critical protections, this coalition underscores our ongoing commitment to ensuring uninterrupted access to high-quality care for all. At the California Department of Justice, we will use every tool at our disposal to safeguard Californians’ health care rights.” 

Section 1557 of the ACA prohibits all health programs and activities receiving federal financial assistance from discriminating against individuals on the basis of race, color, national origin, sex, age, or disability. On June 19, 2020, the Trump Administration issued the Rule implementing Section 1557, severely narrowing the scope of a 2016 Obama rule by eliminating prohibitions preventing health insurers from discriminating against vulnerable populations, including LGBTQ+ individuals, individuals with limited English proficiency, and women, as well as other protected classes. Plaintiffs in BAGLY v. HHS filed a lawsuit on July 9, 2020 in the U.S. District Court for the District of Massachusetts challenging the Rule, and the California Department of Justice filed a separate lawsuit shortly after in New York et al. v. HHS et al. The court allowed many of the plaintiffs’ claims to proceed after the HHS sought a motion to dismiss the case, and plaintiffs now have filed a motion for summary judgment to void and vacate the Rule. 

In the amicus brief, the coalition supports plaintiffs’ motion for summary judgment, arguing that the Rule:

• Improperly narrows the entities covered by Section 1557, thus limiting the protections it provides;
• Removes protections for transgender individuals;
• Exceeds agency authority by expanding “exemptions” to Section 1557’s protections; and
• Is arbitrary and capricious because it fails to consider the harmful impacts of the Rule, such as harms to health care access by transgender individuals and limited English proficient individuals.

The brief also stresses the amici states’ perspective on the importance of upholding these federal nondiscrimination protections, as well as the individual and social benefits of ensuring equitable access to health care.

Attorney General Bonta is committed to safeguarding the health care rights of all:

• Last month, Attorney General Bonta joined 19 attorneys general in a multistate amicus brief in support of the Transgender American Veterans Association’s (TAVA) petition for increased access to gender-affirming care for transgender veterans in TAVA v. Veterans Affairs.
• In December 2023, Attorney General Bonta led 20 attorneys general in filing an amicus brief in Dekker v. Weida in support of transgender rights and equal access to health care.
• In November, Attorney General Bonta led 21 attorneys general in an amicus brief opposing a state law in Oklahoma, severely blocking the ability of transgender youth to access critical, lifesaving gender-affirming care.
• In September 2023, Attorney General Bonta led a multistate coalition of 20 attorneys general in opposing a state law in Indiana that severely blocks the ability of transgender youth to access critical, lifesaving gender-affirming care.
• In August 2023, Attorney General Bonta led a multistate coalition in filing an amicus brief opposing state laws in Kentucky and Tennessee restricting transgender youths' access to critical and lifesaving health care.
• In May 2023, Attorney General Bonta led a multistate coalition in supporting a challenge to a Florida rule restricting access to gender-affirming care and joined another multistate coalition defending a Colorado law that prohibits gay and transgender conversion therapy on children and youth.

Attorney General Bonta was joined by the attorneys general of Massachusetts, New York, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia.

A copy of the amicus brief can be found here.