RFA Sends Letter to Health Leaders about CMS Rules

Dear (Sutter/Kaiser/Stanford/UCSF/Etc) leadership team:

We have been so grateful that you have continued to deliver gender-affirming care to our children in the face of the federal government’s nonstop onslaught of hate and misinformation. Rainbow Families Action and our co-signing organizations represent many of the families you have heroically served, and the impact you have had on our lives is enormous. Your caregivers have been a literal lifeline for many, and the bonds of trust built over time are impossible to replace. It isn’t just the loss of care we fear, but the loss of YOUR care that’s terrifying. We and our children truly love our doctors. 

And now, the appeal: We are reaching out to you because as you know, there are new proposed rules likely to be announced soon for the Centers for Medicare and Medicaid Services (CMS) that may cause some caregiving organizations to rethink or reduce their commitment to gender-affirming care. Please do not waver. There is nothing legally binding in this proposal. Your legal teams will confirm this, but we want to reiterate: A new agency rule does not go into effect until it undergoes the full regulatory process and is formally implemented. Until then, there is no legal reason for any healthcare organization to stop providing services. 

A “proposed rule” or proposed regulation merely announces CMS's intent to issue a new regulation or modify an existing one. Proposed rules must go through a federal regulatory process before they can take effect. At a minimum, there will be a 3-6 month gap after the rule is proposed before it should impact any healthcare services. Additionally, the rule is almost certain to be challenged in court, adding months or even years before it takes effect. 

If you have any further questions about institutional strategies in the face of these rulings, please reach out to Rainbow Families Action at rfa@rainbowfamiliesaction.org, and we can connect you with a CMS rule expert who is currently advising leadership at other healthcare institutions. 

On behalf of our families and families everywhere, we implore you to stand strong. Do not pause care without cause. The CMS rule announcement may feel politically threatening — as it is intended to — but it should not yet impact your daily operations. Meanwhile, any interruption in care would be catastrophic for the families who depend on you. 

Thank you,

Rainbow Families Action

Equality California

PFLAG San Francisco

PFLAG Clayton/Concord

PFLAG Tri-Valley

PFLAG Sacramento

PFLAG San Jose

PFLAG Oakland/East Bay

PFLAG San Ramon/Danville

PFLAG Lamorinda

PFLAG Fremont Tri-Cities

GAYLESTA

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Amor Para Todos

Sage Casey Foundation

LGBTQ Connection