Top of mind: HHS’s reversal of Obama-era transgender nondiscrimination healthcare protections

Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

On June 12, the Trump Administration finalized a rule that proposed to revise, and in effect reverse, Obama-era protections offered in Section 1557 of the Affordable Care Act (ACA). Section 1557, known as the Health Care Rights Law, prevents discrimination of patients based on “race, color, national origin, sex, age, or disability.” In 2016, the Obama Administration expanded the definition of sex to encompass aspects of gender identity as well—extending protections to transgender and gender non-conforming individuals. 

The finalized rule will drastically impact how LGBTQ individuals navigate their health care and health insurance, with regard to nondiscrimination protections. The rule would essentially affect aspects of coverage related to access, cost-sharing, and health plan benefits, specifically, denial of treatment based on someone’s gender transition and/or a provider’s moral or religious beliefs.

The U.S. Department of Health and Human Services (HHS) released a statement following this news expressing that reinstating the original definition of the protections offered would relieve the American people of approximately $2.9 billion in “unnecessary regulatory burdens”. These so-called burdens also include eliminating mandates for regulated entities to provide patients and customers with language accessibility pertaining to health care literature.

Considering the nexus of a global pandemic, civil unrest due to systemic racism, compounded by the epidemic of fatal violence against Black transgender people – the timing of this rule is not only inopportune but exceptionally cruel. The National Consumers League is appalled at the reversal of these protections during a pandemic that is disproportionately impacting vulnerable communities. We urge health insurers and providers to do the right to protect patients by keeping politics out of professional medical judgment when providing services to their patients and customers.