District Court Rules ACA Ban on Sex Discrimination Doesn't Include Sexual Orientation or Gender Identity

Judge Matthew J. Kacsmaryk (N.D. Tex.) ruled that the ban on sex discrimination in the Affordable Care Act doesn't include a ban on discrimination by sexual orientation or gender identity. The ruling concludes that HHS regulations that ban discrimination by sexual orientation and gender identity are unlawful.

The case, Neese v. Becerra, tests HHS regulations against the ACA. The ACA prohibits discrimination "on the ground prohibited under . . . Title IX . . . ." Title IX, in turn, prohibits discrimination "on the basis of sex." HHS interpreted this to include discrimination based on sexual orientation and gender identity, and issued regs prohibiting such discrimination under the ACA.

The court ruled the ACA's ban on discrimination wasn't that capacious. The court said that Title IX's plain language, along with its broader objectives, means that sexual orientation and gender identity are not part of "sex" discrimination under that statute. And therefore they're not a part of "sex" discrimination under the ACA, either.

The court distinguished Bostock v. Clayton County. The Supreme Court in that case held that Title VII's ban on discrimination "because of sex" included a bans on sexual orientation and gender identity discrimination. But the district court said that Bostock only applied to Title VII, not other anti-sex-discrimination statutes, and that differences between Title VII and Title IX meant that Title IX didn't include bans on sexual orientation and gender identity discrimination.