GLMA condemns, in the strongest terms possible, today’s rulings by the U.S. Supreme Court (SCOTUS) in both 303 Creative v Elenis and Biden v Nebraska.
The 303 Creative decision allows a Colorado web designer to refuse to create websites for same-sex weddings because she says it conflicts with her First Amendment right to free expression. This is the first example of SCOTUS upholding a business owner’s right to explicitly violate state laws prohibiting discrimination in sales to a protected class of individuals, and it undermines the foundational protections that public accommodations laws provide against discrimination based on race, religion, sex, sexual orientation, and gender identity in the public marketplace.
The court also ruled today against President Biden’s student loan debt relief plan in Biden v Nebraska. The student loan debt relief program was based on a 2003 federal law known as the Heroes Act which gives the Secretary of the Department of Education sweeping authority to “waive or modify any statutory or regulatory provision applicable to the student financial assistance programs.” The Heroes Act language was authorized by Congress to give the Secretary ultimate authority to either eliminate or change student borrowers’ loan obligations “as the Secretary deems necessary.”
In this case, SCOTUS overruled the decision of both elected branches of government. It overrides Congress’s unambiguous decision to give this power to the secretary of Education; as well as the executive branch’s decision on exercising the authority that Congress previously approved. As Kagan writes in dissent, “the Secretary did only what Congress had told him he could.”
Both these decisions come close on the heels of yesterday’s ruling against race-based affirmative action in the admissions processes for higher education institutions in Students for Fair Admissions v. Harvard. See our full press release on this case here.
This trio of rulings, when viewed in concert, create a very frightening landscape for LGBTQ+ people and all individuals from historically-excluded communities, including the landscape of LGBTQ+ affirming health care. Compounding intersections of these communities will only amplify the negative impacts of these rulings, specifically, for Black, Indigenous, and People of Color (BIPOC) individuals and LGBTQ+ folks with disabilities, who already encounter significant systemic barriers to education and services.
GLMA President Nick Grant, PhD, ABPP, and Executive Director Alex Sheldon, MA, have issued the following joint statement:
"GLMA condemns the three recent SCOTUS rulings, those which gutted Affirmative Action, protected the right to discriminate against LGBTQ+ couples, and blocked the Biden-Harris Administration’s work to forgive student loan debt, respectively. Taken together, these cases mark an extreme shift in legal precedent and the further erosion of the rights of individuals in protected classes and equitable access to education.
Specifically, in 303 Creative v Elenis, this court’s decision has opened the door to the denial of goods and services to LGBTQ+ individuals with wide-reaching implications across many industries, including healthcare. Given that the ‘customer’ in the 303 Creative case did not actually request a same-sex wedding website from the designer, the facts of this case are fictitious and representative of the ongoing weaponization of disinformation against the LGBTQ+ community. This has opened the door for further discrimination in a variety of ways, including in healthcare settings considered public accommodations, and we are only beginning to see the devastating impacts this could have on our community.
Further, by simultaneously reversing decades of precedent regarding affirmative action in school admissions processes and canceling the opportunity for student debt relief, the court has placed higher education further out of reach for many individuals. LGBTQ+ borrowers graduate with an average of $16,000 more in student loan debt than their cisgender, heterosexual peers, and this gap only widens for LGBTQ+ students of color and students who obtained further degrees like those required to enter the health professions.
This will have direct and long-reaching impacts on the diversity of both health professional students and the healthcare workforce. As a result, we can expect to see a decline in the cultural competency of health professionals and worse health outcomes, including but not limited to higher mortality rates, for patients who identify as members of historically-excluded communities.”
GLMA will continue to stand strong in its mission to support diverse and inclusive healthcare systems for the benefit of both patients and providers. This includes an awareness of, and advocacy for, a robust educational system that is accessible both logistically and financially to all communities. We will also refuse to accept a reality where basic goods and services made available to the general public can explicitly be denied to any individual of a protected class, and will move forward with renewed dedication to advocating against these inequitable policies and practices as they unfold in the LGBTQ+ community and beyond.