Q Toon: Now You See It

Shortly after I posted this cartoon to Q Syndicate, news of the Supreme Court's 6-3 decision that legal protections for LGBTQ employees are constitutional. Their rather surprising ruling, written by Trump appointee Neil Gorsuch and joined by Chief Justice John Roberts, has overshadowed the Trump administration's having finalized rules eliminating nondiscrimination protections for LGBTQ persons in health care and health insurance.

"HHS respects the dignity of every human being, and as we have shown in our response to the pandemic, we vigorously protect and enforce the civil rights of all to the fullest extent permitted by our laws as passed by Congress," said Roger Severino, who directs the Office for Civil Rights in the Department of Health and Human Services, in a written statement announcing that the HHS rule had become final. The rule is set to go into effect by mid-August.
It is one of many rules and regulations put forward by the Trump administration that defines "sex discrimination" as only applying when someone faces discrimination for being female or male, and does not protect people from discrimination on the basis of sexual orientation or gender identity.

Section 1557 of the Affordable Care Act ("Obamacare"), prohibits discrimination in health coverage and care. It bans discrimination on the basis of race, color, national origin, sex, age, and disability in health programs and activities that receive federal funding. That these protections include transgender persons is supported by a rule adopted by HHS in 2016 and by most lower courts.

The Corrupt Trump Administration's repeal of the 2016 rule has been a long time coming, however; this is the fourth cartoon I've drawn in as many years about Severino and his determination to allow discrimination against LGBTQ patients and insurance consumers. "We're going back to the plain meaning of those terms, which is based on biological sex," Severino said in 2017, adding that the rule could save hospitals and insurers and others $2.9 billion over five years since they will be relieved of the requirement to print notices of nondiscrimination in several languages.

Under the new rule, a transgender person could, for example, be refused care for a checkup at a doctor's office, said Lindsey Dawson, associate director of HIV policy at the Kaiser Family Foundation. Other possible scenarios include a transgender man being denied treatment for ovarian cancer, or a hysterectomy not being covered by an insurer — or costing more when the procedure is related to someone's gender transition.

Whether this week's court decision will have any impact on Mr. Severino's new rules will depend on having another lawsuit work its way up to the Supremes. The National Center for Transgender Equality is putting on a brave front, but anything can happen. This week's cases turned on Title VII of the Civil Rights Act of 1964, which deals expressly with employment issues and specifically includes protections against sex discrimination. Health care falls under Title VI of the Act, which does not mention sex discrimination.

Will that be enough for Justices Thomas, Alito and Kavanaugh to lasso Roberts and Gorsuch back to the right-wing corral? It is not as if any of them have a great deal of sympathy for Obamacare to begin with.