JACKSON, Mississippi (AP) — A federal district court judge on Wednesday temporarily halted parts of a nondiscrimination rule that would have kept insurers and medical professionals from denying hormone therapy, gender transition surgeries and similar medical care for transgender people.
U.S. District Judge Louis Guirola Jr. sided with 15 states that had argued the language the rule was based on — the 1972 Title IX nondiscrimination law — encompasses biological sex, but not gender identity. Guirola's injunction applies nationwide to the Affordable Care Act rule, which would have gone into effect Friday.
It's another blow to the Biden administration's efforts to expand anti-discrimination protections. In the past few weeks, three federal judges have blocked a rule in several states that would protect LGBTQ+ students by expanding the definition of sexual harassment at schools and colleges under Title IX.
Health care protections based on gender identity had been added under the Obama administration and removed under former President Donald Trump. Earlier this year, the Department of Health and Human Services again broadened the scope of the Affordable Care Act rule to include discrimination based on “sex stereotypes, sexual orientation, gender identity and sex characteristics.”
But the Republican attorneys general in Tennessee and the other states — mostly in the South and Midwest — argued the states would face financial burdens if they followed the new rule under Medicaid or other federal health programs or lose federal funding if they didn't follow the rule. The plaintiffs also argued the rule was based on the federal agency's “commitment to gender ideology over medical reality.”
During testimony, an attorney for the Mississippi Division of Medicaid, Cody Smith, testified that the agency is barred from covering gender transition procedures for children under 18 — which are uncommon — and that the state’s Medicaid program and Children's Health Insurance Program doesn't cover “operative procedures to treat a mental condition.”
Mississippi Gov. Tate Reeves said that the Biden administration "attempted to undermine Title IX by dramatically reinterpreting its meaning to now apply to gender identity.”
“I’m thankful to see that this judge has chosen to side with Mississippi and other states who chose to stand up for women and defend Title IX as it currently exists,” he added.
The U.S. Department of Health and Human Services, the U.S. Office for Civil Rights and the attorneys general for Tennessee and Mississippi did not immediately respond to requests for comment. The office of Tennessee Gov. Bill Lee said it wouldn't comment on pending litigation.
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FILE - Surgeons perform a bilateral mastectomy on a transgender patient at a hospital in Boston on Friday, July 15, 2016. On Wednesday, July 3, 2024, a U.S. federal district court judge temporarily halted parts of a nondiscrimination rule that would have kept insurers and medical professionals from denying hormone therapy, gender transition surgeries and similar medical care for transgender people. (Christine Hochkeppel/Worcester Telegram & Gazette via AP, File)
DEIR AL-BALAH, Gaza (AP) — Hamas has given its initial approval of a U.S.-backed proposal for a phased cease-fire deal in Gaza, dropping a key demand that Israel commit up front to a complete end to the war, a Hamas official and an Egyptian official said Saturday.
The apparent compromise by the militant group, which controlled Gaza before triggering the war with an Oct. 7 attack on Israel, could deliver the first pause in fighting since November and set the stage for further talks on ending a devastating nine months of fighting. But all sides cautioned that a deal is still not guaranteed.
The two officials, who spoke on condition of anonymity to discuss ongoing negotiations, said Washington’s phased deal would start with a “full and complete” six-week cease-fire during which older, sick and female hostages would be released in exchange for hundreds of Palestinian prisoners. During those 42 days, Israeli forces would withdraw from densely populated areas of Gaza and allow the return of displaced people to their homes in northern Gaza, the officials said.
Over that period, Hamas, Israel and mediators would negotiate the terms of the second phase that could see the release of the remaining male hostages, both civilians and soldiers, the officials said. In return, Israel would free additional Palestinian prisoners and detainees. The third phase would include the return of any remaining hostages, including bodies of the dead, and the start of a yearslong reconstruction project.
Hamas still wants written guarantees from mediators that Israel will continue to negotiate a permanent cease-fire deal once the first phase goes into effect, the officials said.
The Hamas representative told The Associated Press the group’s approval came after it received “verbal commitments and guarantees” from the mediators that the war won’t be resumed and that negotiations will continue until a permanent cease-fire is reached.
“Now we want these guarantees on paper,” the representative said.
Months of on-again off-again cease-fire talks have stumbled over Hamas’ demand that any deal include a complete end to the war. Israeli Prime Minister Benjamin Netanyahu has offered to pause the fighting but not end it until Israel reaches its goals of destroying Hamas’ military and governing capabilities and returning all hostages held by the militant group.
Hamas has expressed concern that Israel will restart the war after the hostages are released. Israeli officials have said they are worried Hamas will draw out the talks and the initial cease-fire indefinitely without releasing all the hostages.
Netanyahu’s office did not respond to requests for comment, and there was no immediate comment from Washington. On Friday, the Israeli prime minister confirmed that the Mossad spy agency's chief had paid a lightning visit to Qatar, a key mediator, but his office said “gaps between the parties” remained.
“For the first time in many months, we feel hopeful,” a statement by many families of hostages said. “Netanyahu, we have seen how you repeatedly thwart deals in real time. Don’t you dare break our hearts again.”
Israel launched the war in Gaza after Hamas’ October attack in which militants stormed into southern Israel, killed some 1,200 people — mostly civilians — and abducted about 250. Israel says Hamas is still holding about 120 hostages — about a third of them now thought to be dead.
Since then, the Israeli air and ground offensive has killed more than 38,000 people in Gaza, according to the territory’s Health Ministry, which does not distinguish between combatants and civilians in its count. The offensive has caused widespread devastation and a humanitarian crisis that has left hundreds of thousands of people on the brink of famine, according to international officials.
The cease-fire deal would see around 600 trucks of humanitarian aid entering Gaza daily, with half of them bound for the enclave's hard-hit north, the two officials said. Since Israel's assault on the southernmost city of Rafah, aid supplies entering Gaza have been reduced to a trickle.
“We want to eat, but from where we can eat? The country is exhausted. The country is destitute. It is not suitable for living," said Walid Hegazi, a resident of the Jabaliya refugee camp in northern Gaza. "We’re sorry for the donkeys because we ate their wheat and barley.”
Israel's bombardment in Gaza continued.
At least eight people, including two children, were killed Saturday in an Israeli airstrike that targeted a school-turned-shelter in the Nuseirat refugee camp in central Gaza, Awda hospital authorities said, adding that they also received “a large number of injured, most of them children.” Israel’s military said it was looking into the report.
The Hamas-run Interior Ministry said four police officers were killed in an Israeli airstrike in Rafah. The ministry, which oversees civilian police, said the officers were killed during foot patrols. It said eight other officers were wounded. Israel's military did not immediately respond to questions.
In Deir al-Balah, prayers were held for 12 Palestinians, including five children and two women, killed in three separate strikes in central Gaza on Friday and Saturday, according to hospital officials.
Magdy reported from Cairo, Egypt.
Find more of AP’s coverage at https://apnews.com/hub/israel-hamas-war
People take part in a pro-Palestinian march in central London, Saturday July 6, 2024. (Tejas Sandhu/PA via AP)
Palestinians mourn relatives killed by Israeli bombardment in Khan Younis, southern Gaza Strip, Saturday, July 6, 2024. (AP Photo/Jehad Alshrafi)
Palestinians carry the body of a person killed by Israeli bombardment in Khan Younis, southern Gaza Strip, Saturday, July 6, 2024. (AP Photo/Jehad Alshrafi)
This image from video shows a woman drying clothes, Friday, July 5, 2024 in Gaza City, Gaza Strip. Yarmouk Sports Stadium, once Gaza's biggest soccer arena, is now sheltering thousands of displaced Palestinians who are scraping by with little food or water. (AP Photo)
This image from video shows children sitting amongst rubble in Yarmouk Sports Stadium Friday, July 5, 2024 in Gaza City, Gaza Strip. Yarmouk Sports Stadium, once Gaza's biggest soccer arena, is now sheltering thousands of displaced Palestinians who are scraping by with little food or water. (AP Photo)
This image from video shows a boy sitting amongst rubble in Yarmouk Sports Stadium Friday, July 5, 2024 in Gaza City, Gaza Strip. Yarmouk Sports Stadium, once Gaza's biggest soccer arena, is now sheltering thousands of displaced Palestinians who are scraping by with little food or water. (AP Photo)
Palestinians displaced by the Israeli air and ground offensive on the Gaza Strip walk next a dark streak of sewage flowing into the streets of the southern town of Khan Younis, Gaza Strip, Thursday, July 4, 2024. (AP Photo/Jehad Alshrafi)
Demonstrators supporting Palestinians march during a rally calling to stop genocide in Gaza, in Seoul, South Korea, Saturday, July 6, 2024. (AP Photo/Ahn young-joon)
FILE - Palestinians displaced by the Israeli air and ground offensive on the Gaza Strip walk next to sewage flowing into the streets of the southern town of Khan Younis, Gaza Strip, July 4, 2024. Hamas has given initial approval for a U.S.-backed proposal for a phased cease-fire deal in Gaza, dropping a key demand that Israel gives an up-front commitment for a complete end to the war, a Hamas and an Egyptian official said Saturday July 6, 2024. (AP Photo/Jehad Alshrafi, File)
