Doctors Could Refuse to Treat People Based on Race and Age Under Trump’s New Rule

A new Trump administration proposal would change the civil rights rules dictating whether providers must care for patients who are transgender or have had an abortion. News stories have mainly focused on how the proposal might affect LGBTQ rights and abortion rights, but the sweeping proposal has implications for all Americans, because the Department of Health and Human Services seeks to change how far civil rights protections extend and how those protections are enforced.

Roger Severino, the director of the HHS Office for Civil Rights, has been candid about his intentions to overturn an Obama-era rule that prohibited discrimination based on gender identity and termination of a pregnancy. In 2016, while at the conservative Heritage Foundation, he co-authored a paper arguing the restrictions threaten the independence of physicians to follow their religious or moral beliefs. Supporters of the approach say it protects the freedom of conscience, but opponents say it encourages discrimination.

His office unveiled the proposed rule on May 24, when many people were focused on the start of the long Memorial Day holiday weekend.

The rule is the latest Trump administration proposal to strip protections for transgender Americans, coming the same week another directive was proposed by the Department of Housing and Urban Development that would allow homeless shelters to turn away people based on their gender identity.

The public was given 60 days to comment on the HHS proposal. Here’s a rundown of what you need to know about it.

What would this proposal do?

Fundamentally, the proposed rule would overturn a previous rule that forbids health care providers who receive federal funding from discriminating against patients on the basis of their gender identity or whether they have terminated a pregnancy.

The Trump administration proposal would eliminate those protections, enabling providers to deny these groups care or insurance coverage without having to pay a fine or suffer other federal consequences.

That may mean refusing a transgender patient mental health care or gender-confirming surgery. But it may also mean denying patients care that has nothing to do with gender identity, such as a regular office visit for a bad cold or ongoing treatment for chronic conditions like diabetes.

“What it does, from a very practical point of view, is that it empowers bad actors to be bad actors,” Mara Keisling, executive director of the National Center for Transgender Equality, told reporters.

The proposal would also eliminate protections based on sexual orientation and gender identity from several other health care regulations, like non-discrimination guidelines for the health care insurance marketplaces.

Does it affect only LGBTQ people?

The proposal goes beyond removing protections for the LGBTQ community and those who have had an abortion.

It appears to weaken other protections, such as those based on race or age, by limiting who must abide by the rules. The Trump proposal would scrap the Obama-era rule’s broad definition of which providers can be punished by federal health officials for discrimination, a complicated change critics have said could ease requirements for insurance companies, for instance, as well as the agency itself.

And the proposal erases many of the enforcement procedures outlined in the earlier rule, including its explicit ban on intimidation or retaliation. It also delegates to Severino, as the office’s director, full enforcement authority when it comes to things like opening investigations into complaints lodged under the non-discrimination rule.

Why did HHS decide to change the rule?

The Obama and Trump administrations have different opinions about whether a health care provider should be able to refuse service to patients because they are transgender or have had an abortion.

It all goes back to a section in the Affordable Care Act barring discrimination on the basis of race, color, national origin, age, disability or sex. President Barack Obama’s health officials said it is discrimination to treat someone differently based on gender identity or stereotypes.

It was the first time Americans who are transgender were protected from discrimination in health care.

But President Donald Trump’s health officials said that definition of sex discrimination misinterprets civil rights laws, particularly a religious freedom law used to shield providers who object to performing certain procedures, such as abortions, or treating certain patients because they conflict with their religious convictions.

“When Congress prohibited sex discrimination, it did so according to the plain meaning of the term, and we are making our regulations conform,” Severino said in a statement. “The American people want vigorous protection of civil rights and faithfulness to the text of the laws passed by their representatives.”

Much of what the Office for Civil Rights has done under Severino’s leadership is to emphasize and strengthen so-called conscience protections for health care providers, many of which existed well before Trump was sworn in. Last year, Severino unveiled a Conscience and Religious Freedom Division, and his office recently finalized another rule detailing those protections and their enforcement.

The office also said the proposed rule would save about $3.6 billion over five years. Most of that would come from eliminating requirements for providers to post notices about discrimination, as well as other measures that cater to those with disabilities and limited English proficiency.

The rule would also save providers money that might instead be spent handling grievances from those no longer protected.

The office “considers this a benefit of the rule,” said Katie Keith, co-founder of Out2Enroll, an organization that helps the LGBTQ community obtain health insurance. “Organizations will have lower labor costs and lower litigation costs because they will no longer have to process grievances or defend against lawsuits brought by transgender people.”

Why does this matter?

Research shows the LGBTQ community faces greater health challenges and higher rates of illness than other groups, making access to equitable treatment in health care all the more important.

Discrimination, from the misuse of pronouns to denials of care, is “commonplace” for transgender patients, according to a 2011 report by advocacy groups. The report found that 28 percent of the 6,450 transgender and gender non-conforming people interviewed said they had experienced verbal harassment in a health care setting, while 19 percent said they had been refused care due to their gender identity.

The report said 28 percent had postponed seeking medical attention when they were sick or injured because of discrimination.

Critics fear the rule would muddy the waters, giving patients less clarity on what is and is not permissible and how to get help when they have been the victims of discrimination.

Jocelyn Samuels, the Obama administration official who oversaw the implementation of the Obama-era rule, said that for now, even though the Trump administration’s HHS will not pursue complaints against those providers, Americans still have the right to challenge this treatment in court. Multiple courts have said the prohibition on sex discrimination includes gender identity.

“The administration should be in the business of expanding access to health care and health coverage,” Samuels told reporters on a conference call after the rule’s release. “And my fear is that this rule does just the opposite.”

[VICE]

Trump’s tweet derails House bill opposed by lobbyist with close White House ties

President Trump on Wednesday helped derail a bipartisan casino bill opposed by a key White House ally after tying the measure to Sen. Elizabeth Warren (D-Mass.), a leading Democratic candidate vying to challenge him in 2020.

The intervention by Trump, contained in a morning tweet, eroded Republican support and prompted House Democrats to postpone a vote on the measure, which would pave the way for a new Massachusetts tribal casino.

The bill, H.R. 312, would confirm the Mashpee Wampanoag tribe’s sovereignty over 321 acres of land — including the Taunton, Mass., site eyed for the casino project. It was scheduled for a House vote Wednesday under expedited procedures requiring a two-thirds majority to pass, reflecting its broad support.

But opponents, including Rhode Island lawmakers, have argued that the bill would harm the business of two neighboring casinos across the state line. A key Trump ally, American Conservative Union chairman Matthew Schlapp, is lobbying for Twin River Management Group, which operates both Rhode Island casinos. Schlapp’s wife, Mercedes, is the White House strategic communications director.

In a Wednesday morning tweet that blindsided lawmakers of both parties, Trump urged Republicans to oppose the measure.

“Republicans shouldn’t vote for H.R. 312, a special interest casino Bill, backed by Elizabeth (Pocahontas) Warren,” Trump said, deploying a nickname he has frequently used to deride the 2020 Democratic presidential candidate. “It is unfair and doesn’t treat Native Americans equally!”

Warren co-sponsored a similar 2018 bill introduced by Sen. Edward J. Markey (D-Mass.), but there is no Senate legislation pertaining to the tribe pending in the current Congress. The House bill, introduced by Rep. William R. Keating (D-Mass.), has the support of 15 Democratic co-sponsors, including the entire Massachusetts delegation, as well as six Republicans.

The singular focus on Warren appeared to reflect a strategy embraced by Schlapp, who focused on the senator in a Wednesday morning tweet and an email he sent Tuesday to Republicans on Capitol Hill.

“Potentially giving her a win on such an issue is a real head scratcher,” Schlapp wrote in the email obtained by The Washington Post. It linked to a February story on a conservative website headlined “Warren’s Casino Fiasco.”

In a brief phone interview, Schlapp asked for questions to be texted to him but did not respond to a text or a subsequent phone call. He later referred a reporter to his Twitter feed, where he posted a statement saying that he “lobbied against the casino because it is a “terrible idea” and that his wife “had no role in my advocacy.” Schlapp is well-known in Washington Republican circles as the lead organizer of the annual Conservative Political Action Conference, known as CPAC. A Warren spokeswoman did not respond to requests for comment.

According to a person familiar with the circumstances surrounding the tweet, Trump was happy to attack the project once he learned it was a key priority for Warren. He agreed to send the tweet Tuesday evening, though it was not posted until the next morning, a senior White House official said.

But conservative opposition to the bill was brewing even before Trump’s tweet. White House officials have whipped against the vote in recent days — pointing to objections from the Interior Department, which in 2017 reversed a land decision, prompting the need for legislation.

Two prominent Republican lawmakers — Rep. Tom Cole (Okla.), the ranking Republican on the Rules Committee and a supporter of the tribal legislation, and Rep. Gary Palmer (Ala.), chairman of the party policy committee and an opponent of the bill — sparred in a Tuesday night leadership meeting and again in a Wednesday morning GOP conference meeting. But Trump’s tweet appeared to seal its fate: House Majority Leader Steny H. Hoyer (D-Md.) canceled plans for a vote less than two hours later.

“You get a little racist tweet from the president, and it creates a backwards stampede of people on the Republican side that previously indicated they were voting yes,” said House Natural Resources Committee Chairman Raúl M. Grijalva (D-Ariz.). “The lobbyist for CPAC did a lot of sabotage in the last few days on this issue, and made it a conservative vs. Democrat issue when it’s not.”

A Democratic aide said the Mashpee bill probably will get a vote next week under different procedures requiring only a simple majority to pass.

Cole, a leading GOP voice on Native American issues, said Trump’s tweet was the “precipitating factor” for the bills getting pulled Wednesday and disputed the notion that the bill ought to be dismissed by Republicans because of Warren’s apparent support.

“The communities in the area want it. The state is on record wanting it. Every member of the Massachusetts delegation wants it. Why should we be intervening in a state like that when there is unanimity?” he said. “The real conflict here is between private gaming interests that don’t want Native American competition.”

Cole said he was not aware of Schlapp’s specific involvement in lobbying against the bill or whether he played a role in getting Trump to tweet about it. “I don’t think he knows very much about Indian issues,” Cole said of Schlapp.

Democrats were happy to highlight Schlapp’s possible role while bemoaning the vote’s cancellation Wednesday.

“It is also not lost on anybody that a lobbyist for the Rhode Island casino seems to have a very tight relationship with the White House,” said Rep. Joe Kennedy (D-Mass.), who represents the area eyed for the casino project. “It’s sad. The consequence of this is going to be that the tribe that greeted the Pilgrims gets hurt once again by the U.S. government.”

The bill did, if only briefly, create some strange bedfellows between Trump and the all-Democratic Rhode Island delegation — whose members have worked against the Massachusetts casino plan for months.

“All I’m going to say is, I’m glad the bill was pulled from the floor today for a variety of reasons,” said Rep. Jim Langevin (D-R.I.). “I don’t know the president’s interest or reasoning completely. I’m not going to comment on that.”

Rep. David N. Cicilline (D-R.I.), who spent much of Wednesday at a House Judiciary Committee hearing lambasting Trump and Attorney General William P. Barr, declined to comment on Schlapp’s potential influence on the president.

He pointed instead to the lobbying done by the Mashpee tribe’s foreign investment partners: “There’s been tremendous lobbying on behalf of a Malaysian hedge fund. I’m very concerned about the level of lobbying.”

[Washington Post]

Trump Mocks Warren With Reference to Trail of Tears, Which Killed Thousands

When Senator Elizabeth Warren formally announced her 2020 presidential bid this weekend, President Trump responded with a familiar line of attack.

He mocked Ms. Warren, Democrat of Massachusetts, for her claims to Native American ancestry, again calling her by the slur “Pocahontas.” Mr. Trump then appeared to refer to the Trail of Tears, the infamously cruel forced relocation of Native Americans in the 19th century that caused thousands of deaths.

“Will she run as our first Native American presidential candidate, or has she decided that after 32 years, this is not playing so well anymore?” Mr. Trump tweeted. “See you on the campaign TRAIL, Liz!”

(Ms. Warren had recently apologized to the Cherokee Nation for taking a DNA test to prove her ancestry.)

(Ms. Warren had recently apologized to the Cherokee Nation for taking a DNA test to prove her ancestry.)

The comments drew immediate blowback on social media, with accusations that the president was making light of one of the worst tragedies Native Americans have experienced. Mr. Trump previously invoked the Wounded Knee massacre, one of the deadliest attacks on Native American people by the United States military, in another jab at Ms. Warren.

“He actually is condoning a narrative that supports a genocide and a forced removal,” said Betsy Theobald Richards, who works on changing cultural narratives for the Opportunity Agenda, a social justice organization.

Ms. Richards, a citizen of the Cherokee Nation, said most people have been taught only the “dominant narrative” of history in the United States, which she said has long devalued the experiences and voices of Native American people.

“People don’t really realize these are real people who live among you,” she said. “These are their ancestors that are survivors, or carry on the memory of the people who were massacred or removed.”

For those who need a refresher, here is a brief history of the Trail of Tears:

In the 1830s, federal and state officials forced thousands of Native Americans from their land in the southeastern United States, including Georgia, Alabama and Tennessee. The forced relocation affected thousands of Cherokees, as well as the Creek, Chickasaw, Choctaw and Seminole tribes, among others.

The Native people were forced out of their homes and put in internment camps before they were pushed westward to designated Indian Territory, in present-day Oklahoma, according to the Trail of Tears Association, a nonprofit that works to preserve the historic trail and promote awareness.

Some 15,000 Native people died during the journey from exposure, malnutrition, exhaustion and disease, including about 4,000 Cherokees.

“It’s a terribly tragic event in Cherokee history and looms large,” said Jace Weaver, the director of the Institute of Native American Studies at the University of Georgia, who has studied the Cherokee removal.

[The New York Times]

Trump: I’ll Keep Calling Elizabeth Warren ‘Pocahontas,’ ‘That Name is Too Good to Give Up’

During his Monday pre-midterms rally in Cleveland, Ohio, President Donald Trump told the crowd he intends to keep using his racially-charged, disparaging nickname for Senator Elizabeth Warren (D-MA).

As the president went through a litany of his greatest hits before the crowd, he eventually revived his “Pocahontas” jab at Warren for her controversial claims of having Native American ancestry. Trump bragged about supposedly being right that Warren has “no Indian blood,” but said he’ll retain the nickname for her because “that name is too good to give up.”

Warren’s heritage claims were given renewed attention last month when she publicly released a DNA test that she held up as proof of her Native ancestry. However, Warren’s endeavor met with considerable scrutiny for a number of reasons, so Trump seized on that in recent weeks in order to slam her.

[Mediaite]

Trump Mocks Elizabeth Warren at Event: I Have ‘More Indian Blood’ Than She Does

President Donald Trump mocked Senator Elizabeth Warren at an event on Saturday

Appearing at the Future Farmers of America convention in Indiana, Trump delivered a rally-style speech. After speaking out about the mass shooting at a Pennsylvania synagogue on Saturday morning that left at least 11 dead, Trump turned to his usual topics.

He apparently referenced Warren’s recent claims to Native American heritage when imagining debating her in the 2020 campaign.

“Maybe Elizabeth Warren is gone,” Trump said. “She may be gone. She may be gone. What a sad thing happened to her. Turned out that I had more Indian blood in me than she has.”

As the crowd began to cheer, Trump continued: “What a sad event. And I have none.”

“We can’t resist,” he added. “Can we resist?”

Trump is also set to hold a rally Saturday afternoon. He said he was considering calling off the political rally after the morning’s mass shooting, but later announced it would go on as planned.

[Mediaite]

Trump: Elizabeth Warren ‘Owes the Country an Apology,’ I’ll Give the Money ‘If I Can Test Her Personally’

President Donald Trump took questions from reporters while in Georgia this afternoon surveying the damage from Hurricane Michael.

And he was asked again for his reaction to Elizabeth Warren––whom he has insulted as “Pocahontas” multiple times––releasing her DNA test today.

One reporter asked the President if he owes her an apology. Trump responded, “She owes the country an apology. What’s the percentage? 1/1000?”

Trump was also asked about the money he offered to Warren to prove Native American heritage and he said this:

“You mean, if she gets the nomination, in a debate, where I was gonna have her tested? I’ll only do it if I can test her personally, okay? That will not be something I enjoy doing either.”

[Mediaite]

Trump says ‘who cares’ after Warren takes DNA test, denies $1 million offer

President Donald Trump claims he “didn’t say” that he would pay $1 million to Democratic Sen. Elizabeth Warren for taking DNA test to review her Native American heritage, after she released the results of one on Monday morning.

“Who cares?” Trump said when asked about the DNA test. When pressed on the once-promised $1 million payment, Trump responded: “I didn’t say that. You better read it again.”

In fact, Trump did promise $1 million, during a July rally, but only if the test showed she was “an Indian.”

At a rally in July, Trump said: “And we will say, ‘I will give you a million dollars, paid for by Trump, to your favorite charity if you take the test and it shows you’re an Indian … we’ll see what she does. I have a feeling she will say no but we will hold it for the debates.”

Warren has released the results of a DNA analysis showing she has distant Native American ancestry in an apparent attempt to pre-empt further questions and attacks should she run for president in 2020.

Warren first faced scrutiny for her purported Native American heritage during her 2012 Senate race. But Trump has revived and amplified the controversy as he eyes Warren as a possible rival, frequently mocking her with the nickname “Pocahontas.”

But Warren now has documentation to back up her family lore — a analysis of her genetic data performed by Carlos Bustamante, a professor of genetics at Stanford and adviser to Ancestry and 23 and Me.

Bustamante’s analysis places Warren’s Native American ancestor between six and 10 generations ago, with the report estimating eight generations.
After his initial “who cares” response, Trump said Monday he hopes Warren runs for president because she will be “easy” to beat.

“I hope she’s running for president because I think she’d be very easy. I do not think she’d be very difficult at all,” Trump said, adding: “I don’t want to say bad things about her because I hope she’s one of the people that get through the process.”

Trump added that Warren would turn the US into Venezuela.

[CNN]

Reality

Here is the video of Trump promising to donate $1 million if Warren proved ‘Indian’ ancestry:

Trump: I would offer Warren $1M to prove her Native American heritage

President Trump said Thursday that if he were facing Sen. Elizabeth Warren (D-Mass.) during a debate, he would offer her $1 million to take a test to prove her Native American heritage.

“But let’s say I’m debating Pocahontas, I’ll do this,” Trump said during a campaign rally in Great Falls, Mont., referring to Warren by the racially charged nickname he gave her during the 2016 presidential campaign.

“I promise you I’ll do this, you know those little kits they sell on television for $2? Learn your heritage,” Trump said.

“I’m going to get one of those little kits and in the middle of the debate, when she proclaims she’s of Indian heritage — because her mother said she has high cheekbones, that’s her only evidence,” Trump continued.

“We will take that little kit, we have to do it gently because we’re in the “Me Too” generation, we have to be very gentle,” Trump said mocking the movement that seeks to expose sexual misconduct in media, entertainment and politics.

“We will very gently take that kit and we will slowly toss it, hoping it doesn’t hit her and injure her arm, even though it only weighs probably 2 oz,” he said.

“And we will say, ‘I will give you a million dollars, paid for by Trump, to your favorite charity if you take the test and it shows you’re an Indian,” Trump said. “And we’ll see what she does. I have a feeling she will say no but we will hold it for the debates.”

Trump has repeatedly attacked Warren as “Pocahontas,” most recently doing so at a campaign rally last month in Nevada.

During Thursday’s rally, the president said he wouldn’t apologize to Warren for using the term, but he would apologize to Pocahontas herself.

“Pocahontas, I apologize to you,” Trump said Thursday. “To the fake Pocahontas, I won’t,” he added, referring to Warren.

Warren fired back at Trump on Twitter, accusing him of obsessing over her “genes” while his administration conducts “DNA tests on little kids because you ripped them from their mamas & you are too incompetent to reunite them in time to meet a court order.”

“Maybe you should focus on fixing the lives you’re destroying,” she added.

Warren has acknowledged her past claims that she is of Native American heritage.

“Look, I do know. I know who I am. And never used it for anything. Never got any benefit from it anywhere,” Warren said earlier this year.

[The Hill]

Trump administration to reverse Obama-era guidance on use of race in college admissions

The Trump administration is planning to rescind a set of Obama-era policies that promote using race to achieve diversity in schools, a source familiar with the plans tells CNN.

While the decision does not change current US law on affirmative action it provides a strong illustration on the administration’s position on an issue that could take on renewed attention with the departure of Justice Anthony Kennedy from the Supreme Court.
“The executive branch cannot circumvent Congress or the courts by creating guidance that goes beyond the law and—in some instances — stays on the books for decades,” Justice Department spokesperson Devin O’Malley told CNN in a statement. “Last year, the Attorney General initiated a review of guidance documents, which resulted in dozens of examples—including today’s second tranche of rescissions — of documents that go beyond or are inconsistent with the Constitution and federal law. The Justice Department remains committed to enforcing the law and protecting all Americans from all forms of illegal race-based discrimination.”
The Education Department did not immediately respond to a CNN request for comment.
The move, which was first reported by The Wall Street Journal, comes as the administration has thrown its weight behind a student group that accuses Harvard University of discriminating against Asian-Americans in its admissions process.
Last year, Attorney General Jeff Sessions announced that he was ending the practice of the Justice Department issuing “guidance documents” that have the “effect of adopting new regulatory requirements or amending the law,” without to going through the formal rulemaking process. As a result, 25 documents were rescinded in December.
The guidance that will be reversed Tuesday provided examples of different educational contexts within which institutions could permissibly consider race.
Tuesday’s reversal also does not affect what a school decides to do on its own within the confines of current Supreme Court precedent, but civil rights groups swiftly reacted with disappointment.
“We condemn the Department of Education’s politically motivated attack on affirmative action and deliberate attempt to discourage colleges and universities from pursuing racial diversity at our nation’s colleges and universities,” said Kristen Clarke, president and executive director of the Lawyers’ Committee for Civil Rights Under Law. “The rescission of this guidance does not overrule forty years of precedent that affirms the constitutionality of a university’s limited use of race in college admissions. This most recent decision by the Department of Education is wholly consistent with the administration’s unwavering hostility towards diversity in our schools.”
[CNN]

Donald Trump Says ‘our Ancestors Tamed a Continent’ and ‘we Are Not Going to Apologize for America’

President Donald Trump said at a Naval Academy commencement address Friday that “our ancestors tamed a continent,” adding that “we are not going to apologize for America.”

“Together there is nothing Americans can’t do, absolutely nothing,” Trump told 2018 graduates of the U.S. Naval Academy. “In recent years, and even decades, too many people have forgotten that truth. They’ve forgotten that our ancestors trounced an empire, tamed a continent, and triumphed over the worst evils in history.”

He added: “America is the greatest fighting force for peace, justice and freedom in the history of the world. We have become a lot stronger lately. We are not going to apologize for America. We are going to stand up for America.”

Before Europeans arrived in what became the United States, Native Americans occupied the land but were forced to relinquish territory as the new Americans pushed westward as part of what was termed “manifest destiny.” In 1830, President Andrew Jackson signed the Indian Removal Act, which led to the deaths of thousands of Native Americans.

Trump previously caused controversy when he held an event honoring Native Americans in the Oval Office last November with a portrait of Jackson in the background. Trump has regularly praised Jackson, although at times with a questionable grasp of history. He has also repeatedly referred to Democratic Senator Elizabeth Warren, who has claimed Native American heritage,” as “Pocahontas.”

“A nation must have pride in its history to have confidence in its future,” Trump said Friday. The president’s comments mirrored a tweet he sent out in March celebrating National Agriculture Day.

“Our Nation was founded by farmers,” he wrote. “Our independence was won by farmers. And our continent was tamed by farmers. Our farmers always lead the way — we are PROUD of them, and we are DELIVERING for them! #NationalAgricultureDay

Trump added Friday it was a great time for the graduates to be joining the Navy. “We are witnessing the great reawakening of the American spirit and of American might,” he said. “We have rediscovered our identity, regained our stride and we’re proud again.”

[Newsweek]

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