Tennessee, Mississippi Secure Nationwide Victory As Court Strikes Down ACA ‘Gender-Identity Mandates’
A federal court delivered a nationwide win to a 15-state coalition led by the attorneys general of Tennessee and Mississippi on Wednesday, striking down regulations from the Biden administration that sought to impose gender-identity mandates on healthcare providers and state Medicaid programs under Section 1557 of the Affordable Care Act (ACA).
Court Rules HHS Exceeded Authority
The U.S. District Court for the Southern District of Mississippi held that the Department of Health and Human Services (HHS) exceeded its statutory authority in its May 2024 rule.
The regulation attempted to redefine Title IX’s prohibition against discrimination “on the basis of sex”—which is incorporated into the ACA—to include gender identity.
The court’s final judgment eliminates the contested provisions, which would have forced doctors to perform certain gender-transition procedures and required states to fund them, even experimental treatments, through their Medicaid programs.
The ruling also makes it more difficult for future administrations to revive the mandates.
U.S. District Judge Louis Guirola Jr. determined that when Congress passed Title IX in 1972, the term “sex” meant biological sex, and that federal agencies are not permitted to unilaterally rewrite laws decades later to advance political agendas.
The rule, if enforced, would have represented a federal intrusion into the states’ traditional authority to regulate healthcare and manage their own Medicaid programs.
Specifically, it would have prohibited healthcare facilities from maintaining sex-segregated spaces and required certain providers to administer procedures for gender dysphoria.
AG Skrmetti Hails Constitutional Limits
Tennessee Attorney General Jonathan Skrmetti praised the decision, stating, “When Biden-era bureaucrats tried to illegally rewrite our laws to force radical gender ideology into every corner of American health care, Tennessee stood strong and stopped them.”
“Our fifteen-State coalition worked together to protect the right of health care providers across America to make decisions based on evidence, reason, and conscience,” Skrmetti continued. “This decision restores not just common sense but also constitutional limits on federal overreach.”
Mississippi Attorney General Lynn Fitch co-led the lawsuit. The coalition also included Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Virginia, and West Virginia.
Long-Term Impact
The court’s decision to vacate the illegal provisions nationwide not only halts the immediate effect of the mandates but, according to the states, vindicates the rule of law and the integrity of the medical profession.
The ruling hobbles future attempts by administrative agencies to implement similar mandates by clarifying the statutory scope of Section 1557 of the ACA. The court found that because Title IX, unlike Title VII discussed in the Bostock Supreme Court case, permits sex-based distinctions (like separate living facilities in education), the reasoning used to prohibit discrimination based on sexual orientation and gender identity in employment does not automatically apply to Title IX in the healthcare context.
A federal court delivered a nationwide win to a 15-state coalition led by the attorneys general of Tennessee and Mississippi on Wednesday, striking down regulations from the Biden administration that sought to impose gender-identity mandates on healthcare providers and state Medicaid programs under Section 1557 of the Affordable Care Act (ACA).
READ MORE: University Of Virginia Drops DEI In Deal With DOJ
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