The Department of Health and Human Services (HHS) recently published a final rule that represents a significant advancement toward an inclusive and equitable healthcare system in the United States. This pivotal action by the Biden administration reverses the previous administration’s decision to narrow health care protections against discrimination for gay and transgender people.
In 2020, a policy shift under the Trump administration severely narrowed the definition of sex discrimination under the Affordable Care Act (ACA) to only include “biological sex.” This change effectively excluded transgender individuals from receiving protection against discrimination in health settings, raising serious concerns among advocates about the denial of care and coverage to transgender and nonbinary patients, as well as women who have had abortions.
Thankfully, the Biden administration’s robust response reinstates these critical protections by expanding the prohibition of sex discrimination to encompass sexual orientation and gender identity under Section 1557 of the ACA. This ensures that no individual can be denied healthcare based on their gender identity or sexual orientation.
HHS Secretary Xavier Becerra emphasized the impact of this ruling, stating, “Today’s rule is a giant step forward for this country toward a more equitable and inclusive health care system, and means that Americans across the country now have a clear way to act on their rights against discrimination when they go to the doctor, talk with their health plan, or engage with health programs run by HHS.”
The reinstatement of these protections arrives at a crucial time as numerous GOP-led states have enacted laws restricting access to gender-affirming medical care for children. According to health research group KFF, 24 states have adopted policies that either restrict or outright ban such care for minors, highlighting a stark landscape of health care rights across the nation.
The timing of this rule is also pivotal as the United States approaches the 2024 local and national elections. The stance of candidates on such regulations will be a litmus test for their commitment to health equity and civil rights. As voters, it is essential to recognize the power of our votes to influence policy and protect the rights of all individuals, especially marginalized communities such as the transgender population.
The Office for Civil Rights Director, Melanie Fontes Rainer, noted the profound personal impact of this policy during her travels, saying, “I have heard too many stories of people facing discrimination in their health care. The robust protections of 1557 are needed now more than ever.”
Moreover, the new ruling states that Medicare Part B payments will be considered a form of federal financial assistance. This specification ensures that healthcare providers receiving these funds are prohibited from discriminating based on race, color, national origin, age, sex, and disability, further cementing the administration’s dedication to combating healthcare discrimination at multiple levels.
As the 2024 elections near, it is critical for the transgender community, their families, and allies to stay informed and engaged with the evolving political landscape. The protections reinstated by the Biden administration are a beacon of hope; however, the continuous political and legislative challenges mean that vigilance and advocacy remain crucial.
The recent developments serve as a reminder of the ongoing struggle for equality in health care and the broader societal context. For many, this rule is not merely a policy update; it’s a lifeline that affirms their right to healthcare without prejudice.
As we move forward, let us remain committed to advocating for policies that respect and enhance the rights of every individual, regardless of their gender identity. The health of our democracy—and our communities—depends on it.
