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Radical Redefinition of Sex. On August 4, 2022, HHS published a proposed rule entitled “Nondiscrimination in Health Programs and Activities.”** This rule addresses nondiscrimination provisions of the Affordable Care Act, known as Section 1557, which is enforced by the Office for Civil Rights and the Centers for Medicare and Medicaid Services. Section 1557 prohibits discrimination on the basis of race, color, national origin, age, disability, and sex in covered health programs or activities.

Under the proposed rule, sex is redefined: “Discrimination on the basis of sex includes, but is not limited to, discrimination on the basis of sex stereotypes; sex characteristics, including intersex traits; pregnancy or related conditions; sexual orientation; and gender identity.”*’ In other words, the department proposes to interpret Section 1557 as if it created special privileges for new classes of people, defined in ways that are highly ideological and unscientific.

The redefinition of sex to cover gender identity and sexual orientation and pregnancy to cover abortion should be reversed in all HHS and CMS programs as was done under the Trump Administration. This includes the Children’s Health Insurance Program (CHIP). Low-income families who rely on CHIP should not be coerced, pressured, or otherwise encouraged to embrace this ideologically motivated sexualization of their children.

However, while the Biden Administration’s Section 1557 regulation should be altered and corrected, the lactation room requirements added in the regulation should either be consistently included in any upcoming Section 1557 rulemaking or be proposed in a new individual rule.

COVID-19 Vaccination and Mask Requirements. Health care workers were praised for their self-sacrifice in caring for sick patients at the beginning of the COVID-19 pandemic, but then they were fired if they objected to receiving COVID19 vaccines with or without complying with onerous masking requirements and regardless of whether they already had the virus and had gained natural immunity. With the disease being endemic and constantly mutating, vaccines and universal masking in health care facilities do not have appreciable benefits in reducing COVID-19 transmission throughout the community. Moreover, more recent COVID strains pose fewer health risks than the earlier strains, and the pandemic has been declared to be at an end. CMS should:

• Announce nonenforcement of the Biden Administration’s COVID-19 vaccination mandate on Medicaid and Medicare hospitals.

• Revoke corresponding guidance and regulations.

• Refrain from imposing general COVID-19 mask mandates on health care facilities or personnel.