Once again, the Obama administration is determined to impose its version of reality on a resistant nation by using ObamaCare as its vehicle. On May 13, the same day the administration issued the transgender edicts granting access to public school bathrooms and locker rooms based on nothing more than self-identification, the U.S. Department of Health and Human Services (HHS) issued a ruling in a similar vein. It bans discrimination based on “gender identity” by hospitals, clinics and other health care providers. Thus, the administration’s ongoing insistence that one’s state of mind trumps biological and genetic reality is being pushed in a new arena.

“Since 2010, we have had a prohibition on discrimination on the basis of sex in health care,” said Elizabeth Sepper, a law professor at Washington University in St. Louis. “We never had that before. Sex discrimination was not prohibited in the health-care system.”

This ruling goes far beyond the parameters of sexual discrimination that Congress previously determined, as well as how the overwhelming majority of Americans understand the terms. ObamaCare’s Section 1557 explains that sexual discrimination is prohibited based on an individual’s sex, pregnancy, childbirth and related medical conditions — as well as gender identity and sex stereotyping. And while the Obama administration acknowledges “the final rule does not resolve whether discrimination on the basis of an individual’s sexual orientation status alone is a form of sex discrimination under Section 1557,” it warns that the Office of Civil Rights “will evaluate complaints that allege sex discrimination related to an individual’s sexual orientation to determine if they involve the sorts of stereotyping that can be addressed under Section 1557.”

In other words, fall into line or be subjected to the same loss of federal funding and/or possible government-sponsored litigation used to intimidate school districts, based on definitions of sexual discrimination unilaterally determined by the Obama administration.

That determination has far-reaching consequences. “By prohibiting differential treatment on the basis of ‘gender identity’ in health services, these regulations will penalize medical professionals and health care organizations that, as a matter of faith, moral conviction, or professional medical judgment, believe that maleness and femaleness are biological realities to be respected and affirmed, not altered or treated as diseases,” writes Heritage Foundation research fellow Ryan T. Anderson.

Consider the consequences arising from government demanding specific medical judgments with regard to transgenderism. For example, if a patient demands sex reassignment surgery, will a doctor covered by the new edict be forced to perform it, even if it goes against his medical judgment?

What about the reality that the American College of Pediatricians thoroughly rejects the Left’s entire construct on the subject? How does the Obama administration reconcile ACP’s warning that suicide rates “are twenty times greater among adults who use cross-sex hormones and undergo sex reassignment surgery” or that making children believe “a lifetime of chemical and surgical impersonation of the opposite sex is normal and healthful is child abuse”? How does it run roughshod over the assertion made by Dr. Paul McHugh, former psychiatrist in chief at Johns Hopkins Hospital — a facility that no longer does sex change operations — who insists abiding such medical procedures amounts to collaborating with and promoting a mental disorder?

With regard to religious conviction, on May 15 the U.S. Supreme Court unanimously [ruled][http://www.cnsnews.com/commentary/eric-metaxas/little-sisters-win-unanimous-scotus-decision-big-victory-religious-freedom) in favor of Little Sisters of the Poor and other Christian organizations that refused to abide by the administration’s mandate forcing them to provide employees with contraceptives, including abortifacients. SCOTUS sent the case back to the lower courts with the message that they should accommodate people of faith and prevent their consciences from being violated.

It would appear the medical community is on much firmer ground. First, there is nothing in the Constitution that allows the administration to unilaterally rewrite law or trample on states’ rights in pursuit of an agenda. Second, and far more important, it is virtually impossible to believe the U.S. Supreme Court (if any case goes that far) would overrule a doctor’s medical judgment — with possibly damaging or deadly health results — to satisfy an ideological viewpoint arising from government fiat.

Yet why let it reach that point at all? Congress must reassert its authority over the process of crafting law, ensuring the Obama administration cannot use its interpretation of statutes such as Title IX of the Education Amendments of 1972, Title VII of the Civil Rights Act of 1964, and Section 1557 of the Affordable Care Act to blackmail the nation — and not just regarding the definition of sexual identity.

It is critically important for Americans to remember the advance of regressive ideology is wholly dependent on incrementalism. Re-defining sexual identity is not an end unto itself. It is merely another means in pursuit of the ultimate agenda: unassailable power. And nothing will give that agenda more of a boost than the Obama administration successfully asserting that reality itself is nothing more than a state of mind.

As of now, the new ObamaCare rules will take effect in July and apply to all health care providers receiving federal funds. Thus, medical professionals and health care institutions will be forced to abandon professional ethics, reasonable medical judgment and personal conscience in favor of a radical political agenda. “All at once, the government is changing the way it interprets the law on gender and discrimination,” writes The Atlantic’s senior associate editor, Emma Green. “It’s a relatively new area of civil-rights law, but soon enough, it might just be part of the status quo.”

What status quo? “Perhaps it’s rude to say so, but facts do not cease to be facts simply because they offend,” writes columnist Jonah Goldberg. Maybe not right now, but that’s exactly the status quo the American Left and the Obama administration is pursuing.

And a footnote: The timing of Obama’s latest extraconstitutional executive decree on the states, is, as we have noted previously, to divert conservative political capital away from where it needs to be focused for the next six months – on Hillary Clinton.