Hospice Nurse Alexander Pangborn’s Case Challenges New “1557” Rule

Alexander Pangborn is a hospice nurse in Western Massachusetts. He loves his job, and the patients and families he cares for every day. So Alexander was crushed to discover that his employer would not provide him with healthcare benefits equal to those provided to his coworkers. While preparing in consultation with his doctor to schedule medically-necessary gender-affirming surgery, Alexander learned that his employer had a blanket exclusion for any care related to gender transition. “Along with the stress of not being able to get medical treatment I need, the denial made me feel devalued as an employee and as a person,” Alexander says. “I put my all into my job, and I pay into the same system as all my coworkers to receive medical care, but my employer said that my healthcare isn’t necessary.”
Alexander Pangborn and his wife Katherine
Alexander Pangborn (left) and his wife Katherine
GLAD filed a lawsuit, Pangborn v. Ascend, on Alexander’s behalf in federal court in Western Massachusetts. The suit alleges that by treating him differently — not offering him the same benefits other employees get — because he is a transgender man, Alexander’s employer is discriminating against him on the basis of sex and transgender status, in violation of the nondiscrimination provisions in the Affordable Care Act, as well as Massachusetts and federal employment law. Section 1557 of the ACA bars discrimination in healthcare access and insurance on the basis of sex, as well as race, color, national origin, age, and disability. On June 12, the federal Department of Health and Human Services formalized the Trump administration’s claim that Section 1557 does not protect transgender people, despite multiple court rulings and HHS’s own prior interpretation that the provision against sex-based discrimination applies to transgender status. “The Trump administration’s new 1557 rule contradicts the ACA,” said Jennifer Levi, GLAD Transgender Rights Project Director. “It’s another callous and dangerous attack on transgender people like Alexander, who should be able to access medically-necessary care on the same terms as anyone else. And it’s contrary to established case law, including the recent ruling from the Supreme Court, in the context of employment law, which makes it perfectly clear that sex discrimination by definition includes transgender status discrimination.” As Alexander’s suit continues in court, it will test the legitimacy of Trump’s reversal of healthcare protections for transgender people under the ACA. “Alexander Pangborn is a hospice nurse who provides compassionate care every day to his patients and their families, yet he was denied access to the health care he himself needs,” says Chris Erchull, GLAD Staff Attorney representing Pangborn. “We are fighting alongside Alexander to put an end to the discriminatory practice of excluding transition-related care from health benefits plans.”

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