By PAUL NATINSKY
In the dizzying storm of deregulation and preposterous policy there is so much to sort that some small, but significant developments get only footnote treatment.
Far behind wholesale healthcare coverage cuts, fringe vaccine policy and a baseless assault on acetaminophen during pregnancy, lies Michigan Medicine and Corewell Health’s sudden discontinuance of gender-affirming care for transgender minors, reported by Crain’s Detroit Business Sept. 15.
Seems like just another liability-avoidant preemptive move by a company responding to pernicious and unpredictable federal policy. But it’s not. It’s worse.
Public pressure can work to limit—or reverse—coverage cuts, pediatricians and primary care docs can join together and press ahead with science-based vaccine schedules and push back on false autism narratives. Insurers can choose to stay invested in expert-curated vaccinations, recognizing they save the costs of treating the dread diseases they prevent.
But, “(Corewell Health) said it was discontinuing prescribing puberty blockers or hormone therapy to minors for gender affirmation ‘given the serious risk of legal and regulatory action.’” This means the health system has made a decision about the clinical services it will offer based directly on a hostile and decidedly unscientific political pressure.
Corewell is not alone. Crain’s reported in August that “Michigan Medicine, the University of Michigan’s health system, announced it was halting gender-affirming care for patients under the age of 19 after pressure from the Trump administration.”
These are not decisions made based on evolving science or medical necessity. They have not even been made based on whether or not the systems can make money on such care.
It might seem decisions like these affect elective care for a small population. And anyway, all they have to do is wait a bit and then receive services. Besides, discontinuing such services is a small price to pay to avoid further cuts to a healthcare industry that is busy putting up hurricane shutters in anticipation of the Big, Beautiful Bill making landfall.
But this kind of policymaking crosses bold lines. If which services providers offer can be so easily influenced by anticipated political punches and fiscal feints, where is the line?
It seems preposterous, but imagine hospitals denying care to “suspected” illegal migrants. Maybe progress to Medicaid recipients who have any type criminal record. Or “antifa”-linked individuals. Or maybe just people who have protested against administration policies and rely on government programs to cover or supplement their care.
With so many norms eroding in the face of the Trump tsunami, at least the state’s top lawyer can be heard registering her disapproval.
“They have chosen to capitulate to the federal administration’s discriminatory campaign against the trans community, despite Corewell not being a target of any federal action in this realm,” Michigan Attorney General Dana Nessel was quoted as saying in Crain’s. “Corewell’s shortsighted approach to conform their treatment options and ‘obey in advance’ fails to adequately consider the long-term consequences to the health, safety and well-being of their patients.
“Michigan law has not changed; gender-affirming care remains legal and is approved healthcare by leading healthcare associations,” she added.
Nessel’s office has filed a legal challenge to the Trump administration’s actions, and at least one court has found the Trump administration’s actions are unlawful, according to Crain’s.
Perhaps it’s time for Michigan’s healthcare community puts its shoulder to this wheel and join the fight.