According to NPR’s reporting, these rules are a dramatic expansion of power and an unprecedented type of executive rulemaking. However, members of the public could still make their voices heard and pressure the rules to be dropped.
On Oct. 30, NPR reported that the Department of Health and Human Services is considering new rules that would force hospitals and health providers to choose between continuing to receive Medicare and Medicaid funding, or continuing to provide necessary healthcare to trans youth and young adults.
According to NPR’s reporting:
“Both supporters and opponents of transgender rights agree that, taken together, the forthcoming rules could make access to pediatric gender-affirming care across the country extremely difficult, if not impossible. The care is already banned in 27 states.
"These rules would be a significant escalation in the Trump administration's attack on access to transgender health care," says Katie Keith, director of the Center for Health Policy and the Law at Georgetown University.
"I think it's really, really important to note that nothing is changing immediately," she explains. "These would be proposals that would go out for public comment, it would take months for the Trump administration to issue a final rule, and then, if past is prologue, we would see litigation over whatever the final rules are."”
According to the federal register, the most recent meeting that was completed by the HHS about these rules was on Sept. 30. That meeting involved 5 people, all via teleconference, per public records.
Those 5 people were,
For the other proposed rule, the national woman’s law center requested a meeting, which was held via teleconference on Sept. 9.
The people present were,
According to the Office of Information and Regulatory Affairs, any member of the public can request a meeting regarding upcoming rules. These are called E.O. 12866 meetings.
In addition, once the rules are made public, they are subject to a public comment period before taking effect.
E.O. 12866 meetings are semi-public. They inform the federal government while it is considering rules and are not considered public comments, unlike anything in the public comment period after a rule is made public.
This means that anyone who attends an E.O. 12866 meeting is in public record, but the meetings themselves are generally not entered into the public record.
In theory, any member of the American public could request an E.O. 12866 meeting to discuss these rules before they go public, forcing the rulemakers to hear the lived or empirical evidence about what the rules would do, and who they would hurt.
According to OIRA, “Your perspectives in these meetings are most useful to the Federal government if they are evidence-based or reflect your own lived experiences with government policies. For instance, you might share how a regulatory action could impact your family's life, or the way that your small business works.”
To schedule a meeting, a concerned member of the public needs the RIN- Regulation Identifier Number.
The RINs for the two proposed rules are as follows.
RIN: 0938-AV87 - Medicare and Medicaid Programs; Hospital Condition of Participation: Limiting Participation Based on the Performance of Sex Trait Modification Procedures on Children.
RIN: 0938-AV73 - Medicaid Program; Prohibition on Federal Medicaid Funding for Sex Trait Modification Procedures Furnished to Children and Youth (CMS-2451)
According to NPR’s reporting, these rules are a dramatic expansion of power and an unprecedented type of executive rulemaking.