Joe Biden’s LGBTQ+ healthcare plan at risk due to Trump-appointed judge

Federal district judge Matthew Kacsmaryk speaks before a judiciary committee wearing a blue suit, with an audience behind him.

A piece of legislation aiming to prohibit LGBTQ+ healthcare discrimination could be at risk due to a Trump-appointed court judge.

Lawmakers proposed expansions to the Affordable Care Act (ACA) – often referred to as “Obamacare” – which would prohibit discrimination on the basis of gender identity or sexual orientation.

But progress on LGBTQ+ healthcare was mitigated after federal district judge Matthew Kacsmaryk ruled that the bill’s definition of a person’s sex was too “narrow”.

After a recent Supreme Court ruling on Bostock v Clayton found that gender discrimination in employment counts as sex discrimination, lawmakers argued that the ACA now constituted broader discrimination clauses.

Biden stands speaking to a crowd through a microphone.
The Biden administration has routinely planned to expand LGBTQ+ discrimination protections in the ACA. (Getty)

But Kacsmaryk hit back in his ruling, stating that “Bostock decided only what Bostock decided.”

“Bostock does not prohibit employers from discriminating on account of sexual orientation or gender identity, so long as they do not engage in ‘sex’ discrimination when doing so,” the ruling opinion read.

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The judge’s declaration that the Supreme Court’s ruling on LGBTQ+ healthcare does not extend to discrimination against the LGBTQ+ community has led to criticism from activists.

Lambda Legal senior counsel and director Karen Lowey said: “There’s no question that this has created a mess for the agency.

“[The ruling] purports to basically shield all healthcare entities across the country from having to comply with a federal statute to which they are subject.”

Other groups cited jurisdictions that could contradict the ruling, adding that it “doesn’t mean discrimination against LGBTQ+ in healthcare is now legal”.

Federal district judge criticised for right-wing views

Kacsmaryk has been continuously criticised for his right-wing political views.

The federal district judge ruled in a November case that LGBTQ+ healthcare discrimination against queer people is perfectly legal.

After two Texas doctors filed a case over concerns they would lose money for denying transgender patients gender-affirming care, Kacsmaryk ruled on 11 November that clauses against LGBTQ+ discrimination were absent from the ACA.

Additionally, Matthew Kacsmaryk has routinely attacked the constitutional right of same-sex marriage for LGBTQ+ couples.

In 2019, 70 LGBTQ+ groups, led by Lambda Legal, wrote to Congress opposing his judicial nomination because of these beliefs.

“Matthew Kacsmaryk has challenged LGBT people’s right to form families at all, and argued that the
families that they have formed are less legitimate than other families,” the letter read. “He has denied in some cases that LGBT people really exist.

“His record reveals that he will be incapable of treating LGBT litigants fairly – no matter what body of law is at issue in the cases over which he may preside – because he does not acknowledge LGBT people as having a right to exist.”

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