Latest news with #SB99
Yahoo
14-05-2025
- Health
- Yahoo
District Court strikes down ban on gender-affirming care for trans youth
The Missoula County Court House pictured on December 20, 2020. A Montana District Court struck down a law on Tuesday banning gender-affirming healthcare for transgender youth. Missoula County District Court Judge Jason Marks permanently enjoined SB 99, from the 2023 Legislative session, and declined to hear remaining claims from the plaintiffs in the case, Cross et al vs. State of Montana. The lawsuit was filed by a coalition of minors and providers as well as the American Civil Liberties Union. In 2024 the Montana Supreme Court upheld an injunction against the law being put into place. 'I will never understand why my representatives worked so hard to strip me of my rights and the rights of other transgender kids,' Phoebe Cross, a 17-year-old transgender boy who was a plaintiff in the case, said in a release. 'It's great that the courts, including the Montana Supreme Court, have seen this law for what it was, discriminatory, and today have thrown it out for good. Just living as a trans teenager is difficult enough, the last thing me and my peers need is to have our rights taken away.' Mark's order said SB 99 was discriminatory, prevented trans people from accessing medical information and that it infringed on the plaintiffs' right to privacy, among other issues the court found with the law. The law would have banned the use of treatments like puberty blockers and surgeries, which are gender-affirming care. The law also would not have banned the same sort of treatment for cisgender children. 'The Montana Constitution protects the privacy and dignity of all Montanans,' Akilah Deernose, ACLU-MT Executive Director said in a release. 'In the face of those protections, cruel and inhumane laws like SB 99 will always fail. Today's decision should be a powerful message to those that seek to marginalize and harass transgender Montanans.' Defendants in the case also pointed to 'detransitioners' as an argument to support their case that the law was protecting minors. The court said it would lead to 'absurd' results. 'Under Defendants' reasoning, the State could infringe on minors' fundamental rights whenever any minor was protected at the expense of the majority of minors,' the order reads. 'For example, the State could categorically ban all influenza vaccines for all minors in an effort to protect the small percentage of minors who experience allergic reactions to that vaccine. This line of reasoning would lead to absurd results.' The court also said the state's interest in the case was 'political and ideological.' Lambda Legal, which helped bring the lawsuit, also pointed to another case it's supporting, with the U.S. Supreme Court expected to soon rule on U.S. v. Skrmetti. That case challenges a Tennessee ban on gender-affirming hormonal therapies for transgender youth, saying the law violates the Equal Protection Clause of the U.S. Constitution. The state could appeal the decision to the Montana Supreme Court, but representatives from the AG's office did not respond to a request for comment about the ruling. May13CrossOrder
Yahoo
25-04-2025
- Health
- Yahoo
Judge takes up gender-affirming care arguments in Missoula County District Court
The Missoula County Court House pictured on December 20, 2020. Missoula County District Court Judge Jason Marks peppered questions at a lawyer for the State of Montana in a hearing Thursday about whether a bill that bans gender-affirming care for minors is constitutional. In 2023, the Montana Legislature adopted, and Gov. Greg Gianforte signed, Senate Bill 99, which banned gender-affirming care for minors in Montana. The bill also opened up providers to punishment and civil actions. A coalition of minors and providers sued the state, and in December 2024, the Montana Supreme Court found the District Court in Missoula was correct in temporarily blocking the law based on privacy rights in the state Constitution. Thursday, Marks heard arguments for summary judgment, or a decision without a trial based on the facts already presented. ACLU of Montana lawyer Alex Rate argued the case, Cross et al v. State of Montana, is parallel to abortion lawsuits in which courts have granted summary judgment based on the state's constitutional right to privacy. Those abortion cases have been unanimously upheld by the Montana Supreme Court. In a separate case regarding an executive order, Rate said, 'the federal court there said, quote, the evidence supporting gender affirming care for adolescents is as robust as the evidence supporting other pediatric treatments.' However, Michael Noonan and Thane Johnson for the State of Montana said a trial is warranted. Noonan said the parties disagree on many material facts, such as the harms of gender-affirming care, and experts are offering differing opinions that need to be sorted out. 'A trial is the appropriate time to evaluate the merits of the competing evidence presented in this case,' Noonan said. In his argument, Noonan said the state Constitution gives the state the power to protect minors in Article 2 Section 15, and SB 99 'clearly enhances the protection of minors.' He said care can leave people infertile or irreversibly physically damaged, it isn't proven to reduce the risk of suicide, and some countries in Europe, which had been the 'vanguard' of such treatments, have since reversed course. Meanwhile, Noonan said, some people in the U.S. end up rushed into gender-affirming care, without an adequate or even any psychological evaluation. When the government has a 'compelling interest,' such as protecting a minor, it can enforce a law designed to be narrow enough to address that interest. In one of many questions for Noonan, Marks said he wanted to know why the law bans the treatment altogether. Instead, Marks said, it could have required extra evaluations before allowing a patient to grant 'informed consent,' a voluntary decision to receive a medical intervention with knowledge of its risks and benefits. 'I don't see this as narrowly tailored to the problem you're addressing. Can you help me with that?' Marks said. Marks also said the idea that people under 18 can't give informed consent doesn't seem to be supported by Montana law. Noonan said Montana's approach in SB 99 aligns with Europe's approach, which starts with psychotherapy, but doesn't rush into gender-affirming care. He said in the U.S. minors are being hurried into treatments that might be unnecessary, and they don't get the 'full scope' of what might alleviate their gender dysphoria, the condition of feeling like one's gender is out of alignment with one's sex at birth. But Marks said under the law, even minors who had gone through an extensive evaluation and continued to experience gender dysphoria would not be able to receive gender-affirming care. 'Doesn't that seem problematic?' Marks said. The judge also said Montana offers a higher degree of privacy protection than other states. Additionally, Marks said he struggled with the idea that the legislature could ban a certain treatment because the possibility of a negative outcome, a conclusion he saw in the state's argument. For example: What about a concern stemming from a debunked claim that measles vaccines cause problems? Noonan argued the parallel didn't apply: 'There was one study that's been clearly debunked, and the medical consensus, at least I would say globally, is that vaccines are fine. We don't have the same facts here.' Marks, though, said he wrestled with the idea the state had a legitimate position in its blanket ban on gender-affirming care when minors already can give consent to treatments that can result in other serious harms or even death, such as surgery to remove a brain tumor. 'Under Montana law, this is literally the only treatment that a child cannot give informed consent to,' Marks said. ' … Why do you think that's a defensible position?' Noonan said adolescents don't always choose wisely, it's not a lifelong ban, and the decisions are heavy and consequential, such as infertility. 'Can they even weigh what that means in the future, and will that matter to them?' Noonan said. Rate said the state offered claims about gender-affirming care from 'experts who don't treat gender dysphoria' and witnesses who don't have any connection to Montana. He said it had to look to Europe for its arguments, although no country offers a ban as 'draconian' as Montana's, and the two that the state identified are in the United Kingdom, which he said allows hormones at 16. He said the 'true justification for Senate Bill 99' is 'animus, plain and simple.' Rate, for the ACLU of Montana, said the case is actually simple and straightforward. Rate said the cases that offer the legal framework are abortion cases in Montana, which have been decided on summary judgment without trial 'almost without exception.' The plaintiffs are Phoebe Cross, a transgender minor, and parents Molly and Paul Cross; a couple of medical providers Juanita Hodax and Katherine Mistretta, on behalf of themselves and their patients; and a John Doe and Jane Doe. Their legal team also includes ACLU's National LGBT & HIV Project, Lambda Legal, and Perkins Coie. As for the legal framework, Rate said the right to privacy for abortion is parallel in this case for gender-affirming care, and privacy is protected in the Montana Constitution. 'Health care decisions should be made between an individual and their health care providers, not by the legislature, not by the executive, not by the courts,' Rate said. He said the state had argued that abortion comes with great risk of complications, and the state had a right to protect its citizens. But Rate said in Weems et al. vs. State of Montana and other cases, the court found the state could not show the laws were narrowly tailored to address the concern. He also pointed to rulings in Planned Parenthood vs. the state of Montana and Armstrong vs. the State of Montana. Additionally, he said, the state's argument about a high health risk didn't hold up when compared to abortion. In another parallel case, he said the court found a medical protocol — endorsed by major medical organizations — was prohibited for abortion care, but the identical protocol was allowed for miscarriages. But in that case, the court found there can't be 'a bona fide health risk' if the protocols are the same, he said. Rather, Rate said, 'the state made a values judgment that it doesn't like abortion.' In fact, he said, in another case about parental consent, the state argued a minor was not mature enough to decide to get an abortion, but the court struck down that law as well, finding the state's interest wasn't compelling, or narrowly tailored. The state argued some people regret gender-affirming care, and Rate said some people periodically regret abortion too, but that doesn't justify making it illegal. Even if the judge accepted the state's 'overly inflated' data point that 30% of people who experience such care regret it — 'which we vigorously dispute' — he said it would still mean 70% don't regret it, but would be banned from receiving it. Even in the Cross case, he said, the court has provided a clear roadmap to strike down SB 99 as unconstitutional. Rate also shared the results of gender-affirming care for one of the team's clients. 'Our client Phoebe Cross has flourished as a result of receiving gender affirming care,' Rate said.
Yahoo
26-02-2025
- Health
- Yahoo
More than a hundred local pharmacies walkout, asking for PBM reform in Alabama
DECATUR, Ala. (WHNT) — More than a hundred locally-owned Alabama pharmacies turned off the lights, shut their doors and closed Tuesday afternoon. The unprecedented walkout is meant to call attention to proposed state reforms that would increase how much independent pharmacies are paid. Eating Disorder Awareness Week: Clinician shares importance of knowing signs, seeking treatment Neighborhood pharmacies are disappearing from communities across Alabama. Pharmacists say they are not being reimbursed as much as their corporate counterparts, and the profit gap is hitting them hard. Change could come from the state legislature this year. Two introduced bills would create reforms for pharmacy benefit managers (PBMs). PBMs are the intermediaries between pharmacies and insurance companies, and they negotiate how much the pharmacy makes when you pay for your prescription. Chase Arrington, the owner of River City Pharmacy in Decatur, said many independent pharmacies are not making enough to survive. 'I think if something doesn't happen this legislative session, probably within a year or two there, there may not be any local pharmacies,' Arrington is asking state lawmakers to take on the system led by PBMs, who generally pay higher rates to corporate pharmacies. They are often affiliated with these pharmacies under the same company's ownership. CVS Health is the largest PBM with 21% of the U.S. market, followed by Optum RX, which is owned by United Health Group. Blue Cross, owned by Prime Therapeutics, has 10% of the market. 'Patients are already being steered to corporate-owned pharmacies or mail order and a lot of times that's not even what they want to do, that they're kind of forced that way,' Arrington said. Currently, PBMs can deny coverage for certain drugs at small pharmacies, and prescriptions are sometimes more expensive at a local drugstore than they would be at a large chain. Two Senate bills, SB 93 and SB 99, look to address these issues. SB 99 would offer more regulatory power to the Department of Insurance so it could set benchmarks for reimbursement. Both bills would require PBMs to pay pharmacies for the cost of dispensing drugs, and they call for those payments to come from PBM profits, not from consumers. Mother, stepfather of missing children found in Wyoming extradited to Alabama 'The healthcare system in this country is broken,' Arrington said. 'We all know that we're worried that the cost for health care for patients is continuing to climb and pharmacies are closing in every week. We just feel like PBM reform is important this legislative session to keep our patients' access to care there.' As a part of Tuesday's walkout, many local pharmacies are asking their customers to contact state lawmakers and tell them they support PBM reform. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
25-02-2025
- Business
- Yahoo
‘We're fighting to keep them open': pharmacies across the state struggle to make ends meet
ALABAMA (WHNT) — Bags crinkling and staplers snapping are heard less and less at pharmacies across Alabama. Pharmacists in the state, like Bob Giles with the Alabama Pharmacy Association, said they are not reimbursed properly by Pharmacy Benefit Managers, or PBMs. In short, they said they lose money when they fill prescriptions for patients. Pharmacists across Alabama to participate in walkout for PBM reform 'There's not a business out there, health care provider or otherwise, that can continually be paid less than the cost of dispensing or less than the cost to provide that service and stay in business,' Giles said. Roughly 13% of drugstores across Alabama have closed since 2018, according to the Alabama Independent Pharmacy Alliance. In response to the complications and challenges within the pharmacy industry in recent years, some local pharmacies are temporarily shutting their doors on February 25 at 1 p.m. The walkout is in support of Senate Bill 93, a bill proposing to reform the current payout structure. '93 is a very, condensed version of the Fair Meds Act that was introduced last year in the House,' Giles said. 'So it addresses reimbursement. It addresses transparency and the ability to tell the truth, gets rid of the fees associated with network participation and then has enforcement.' Your Wellbeing: The importance of heart health in young patients While most pharmacies feel the impacts of current state policies, not all are participating in the walkout, such as Huntsville's own Star Discount Pharmacy. Trent McLemore, the Director of Star Discount Pharmacy, said they support all reform efforts. He added that the pharmacy has made an effort to educate all their patients about the struggles pharmacies face over the last 11 months. Because of those efforts, he said participation in the protest seemed unnecessary. 'I felt it sent the wrong message to close our doors when we're fighting to keep them open,' McLemore said. McLemore presented to the Senate Banking and Insurance Committee on February 19 in favor of reform, focused on the protections Star Discount Pharmacy has at its Tennessee location. He said they have sent roughly $12 million across state lines since August to keep their doors in Alabama open. 'They passed legislation in Tennessee to protect their pharmacies, all pharmacies, from being paid below cost,' McLemore told News 19. 'As a result, we've sent quite a number of prescriptions, a lot of business to our Tennessee store. It's been able to allow us to keep our patients here, not turn them away. Not tell them they have to find their medication elsewhere because we're taking a loss.' McLemore's presentation showed support for Senate Bill 99, not 93. He said the two have a lot of similarities in the reform they want for pharmacies, but that SB 99 offers protections for employers. 'SB 99 and SB 93 both protect the patient from any increase in cost,' McLemore said. 'SB 99 also protects the employer by requiring rebates to be passed back to them. Employers, patients, pharmacies, everybody wins except for the PBMs.' McLemore emphasized the importance of having local pharmacies in the community. 'We, as independent pharmacies, show up after hours and take care of somebody,' McLemore said. 'We're the ones that, you know, take care of you when no one else will.' Giles said the reforms proposed in state legislation do not affect any federally funded healthcare plans, such as Medicare. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
28-01-2025
- Health
- Yahoo
Montana Senate Judicial committee takes up bill that criminalizes care for transgender youth
Sen. John Fuller, R-Whitefish, waits to present Senate Bill 164, which would make procuring or providing certain care for transgender youth a felony. (Keila Szpaller/The Daily Montanan) A doctor couldn't fix a cleft palate on a baby or circumcise an infant if Senate Bill 164 takes effect, said one medical provider. Another doctor said a child with scoliosis couldn't be treated if the bill is signed into law. Several people who testified said suicide rates among transgender youth will increase. The Senate Judiciary committee on Jan. 27 heard testimony on SB 164, which would make it a felony for a parent or medical provider to procure or provide treatment to alter the appearance of a child younger than 16 or to provide surgical treatment, puberty blockers or doses of estrogen or testosterone to affirm a transgender child's identity. Sen. John Fuller, R-Whitefish, sponsored the bill, which comes with a penalty of up to five years in prison or a $10,000 fine, or up to 10 years and $25,000 if a 'child suffers serious bodily injury.' In 2023, the Montana Legislature passed and Gov. Greg Gianforte signed Senate bill 99, which made it illegal for young people who are transgender to receive gender-affirming care. The ACLU of Montana sued on behalf of plaintiffs and opposed SB 164 too. Monday, Fuller said the Montana Supreme Court already found SB 99 to be unconstitutional — although Derek Oestreicher of the Montana Family Foundation corrected him and said it has only been preliminarily enjoined. However, Fuller said his bill is different because it is amending a different section of code, one that addresses endangering the welfare of children. Representatives from the Montana Family Foundation and Montana Medical Freedom Alliance were among the handful of proponents who testified in support of the bill. Oestreicher said gender dysphoria, where a person feels their biological sex doesn't match their gender identity, is a 'deeply complex and personal experience,' and the bill seeks to ensure children aren't subjected to 'life altering consequences' from treatment. 'This legislation is critical to protecting Montana children from harmful and irreversible medical interventions,' Oestreicher said. In December, the Montana Supreme Court found SB 99 likely violates the state constitution's right to privacy, and the law is temporarily blocked while the lawsuit plays out. At the hearing Monday, many members of the medical community including counselors and an emergency room doctor testified against the bill. They said doctors are sworn to present the best options to patients, and the bill would make them and parents criminals for offering them necessary care and potentially increase suicide rates among children. Dr. Cathy White had retired as a pediatrician, but she came out of retirement because of a shortage of providers in Butte. White said if the bill passes, shortages will get worse. Some transgender youth don't experience any dysphoria at all, but White has had patients come into her office and say, ''If my body keeps changing like this, I'm going to kill myself.'' White said the use of puberty blockers isn't taken lightly, but they have been used for decades, and she will quit working if the bill passes. 'Personally, I'm too old to risk a felony if this law passes, and I would cease to practice in Montana,' said White, past president of the Montana Chapter of American Academy of Pediatrics. The Movement Advancement Project lists 24 states including Montana that have bans, not all in effect, on 'best practice' care for transgender youth. MAP describes itself as a nonprofit think tank dedicated to research that supports equality. Dr. Lauren Wilson, with the Montana Chapter of the American Academy of Pediatrics, presented the committee with a list of 43 medical organizations, including the American Medical Association, that have issued statements in support of medical care for transgender patients and against restrictions that criminalize them. Wilson, also testifying for the Montana Academy of Family Physicians, told the committee it's important to recognize transgender and intersex people have existed across cultures and throughout history. No single pathway exists for youth seeking gender affirming care, Wilson said. In some cases, support entails allowing a child to get a different haircut or use a different name. Of adolescents seen in a gender clinic in a large children's hospital, 65% received no medication or other interventions, Wilson said. Just 7% received puberty blockers, and 35% received hormones. Children don't undergo surgery, and just 25% to 35% of people who are transgender have ever had surgery, Wilson said. 'Bills like this one are based in misconceptions about gender affirming care that are circulating nationally,' Wilson said. Planned Parenthood of Montana, the Montana Hospital Association, Montana Primary Care Association, a member of the Montana Psychiatric Association, the Women's Foundation of Montana, and a pastor were among the opponents who testified. Faye Wilde said before she was a transgender woman, she was a trans child, and she knows she would have faced less harassment if she had had access to puberty blockers early on. Wilde described the bill as cruel and 'blatantly unconstitutional,' and she said transgender people have always existed in Montana, 'and we always will.' 'You cannot legislate us back into the closet, into the grave or out of existence,' Wilde said. 'We are here, and here we will remain.' The bill has no fiscal note, but it would be costly for public defenders and child and protective services, said Kelsen Young, with the Coalition Against Domestic and Sexual Violence. Young said the coalition stood in 'indignant opposition' to the bill. Some parents won't testify in opposition because they fear prosecution, said Young, who identified herself as a mother and grandmother. 'Please know that this is a life and death situation,' Young said. 'The fact that we are creating a felony for parents who are doing the best they can in these incredibly difficult situations is offensive to those of us who work with children.' Anna Louise Peterson, a licensed clinical professional counselor, has provided support to transgender, nonbinary and intersex clients for the last 25 years. 'I have yet to see a single case in which the treatment protocol has caused any harm to any of my clients. Quite the opposite. It has enabled them to thrive,' Peterson said. Shawn Reagor, on behalf of Bridger Care, Montana's largest nonprofit reproductive and sexual health clinic, said the bill aims to block treatment that saves lives. Reagor said it also affects less than 0.1% of the population in the country, fewer than 3,000 people, and the bill is a waste of time and money. 'The government has no place inserting itself between parents, teens and their trusted health care providers,' Reagor said. In support of the bill, however, Erin Laws, with the Montana Medical Freedom Alliance, said voters gave Americans and Montanans a clear mandate in the most recent election to return to 'common sense' and traditional values. Laws also pointed out that a doctor who had received nearly $10 million from the U.S. government for a study regarding puberty blockers declined to release the full results. 'She refused to release the findings because she did not want them to be weaponized,' Laws said. The committee did not take immediate action on the bill on Monday.
