White House strengthens transgender health protections and reverses Trump administrative rule

The Biden administration is strengthening health care protections against gay and transgender discrimination, reversing a Trump administration rule that gutted the protections.

In a sweeping final rule released Friday, the Department of Health and Human Services (HHS) strengthened Affordable Care Act (ACA) rules that prohibit discrimination on the basis of sex, including on the basis of sexual orientation and gender identity. , in certain health programs and activities.

“Today’s rule is a giant step for this country toward a more equitable and inclusive health care system, and it means that Americans across the country now have a clear way to act on their rights against discrimination when go to the doctor, talk to their health plan or get involved with health programs administered by HHS,” HHS Secretary Xavier Becerra said in a statement.

The rule involves protections in Section 1557 of the ACA that prohibit discrimination on the basis of race, color, national origin, sex, age, and disability in certain health programs and activities.

The final rule comes as GOP-led states are restricting access to gender-affirming medical care. According to the health research group KFF, 24 states have enacted laws or policies to restrict or prohibit gender-affirming care for children.

The previous administration’s policy maintained protections against discrimination based on race, color, national origin, sex, age, or disability. But the update narrowed the definition of sex to mean only “biological sex,” excluding transgender people from protections.

Advocates were concerned that previous policies had made it easier for doctors, hospitals and insurance companies to deny care or coverage to transgender and non-binary patients, as well as women who had abortions.

The Biden administration made clear in the rule that federal protections for religious freedom and conscience still apply. These protections say that health care providers do not engage in discrimination if they refuse to provide abortion or any other care that conflicts with a “sincerely held belief.”

“Today’s rule exemplifies the Biden-Harris Administration’s ongoing commitment to health equity and patients’ rights,” said HHS Office for Civil Rights Director Melanie Fontes Rainer. “Traveling across the country, I have heard many stories of people facing discrimination in their health care. 1557’s robust protections are needed now more than ever.”

Section 1557 has been controversial from the beginning and has been the subject of ongoing litigation. The Obama-era rule made it illegal for doctors, hospitals and other health care professionals to deny care to someone whose sexual orientation or gender identity they disapproved of.

The White House under former President Trump issued a final rule rolling back the protections in June 2020, but the day before the rule took effect, a federal judge blocked aspects of the policy and said a Supreme Court ruling on discrimination in the workplace contradicted the new policy.

That ruling concluded that federal laws against sexual discrimination in the workplace also safeguarded gay and transgender people.