The Department of Health and Human Services (HHS) issued the final rule on Obamacare’s (Affordable Care Act’s) Section 1557 Friday, stating it will “help to advance equity and reduce health disparities by protecting some of the populations that have been most vulnerable to discrimination in the health care context”.
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The regulation “prohibits discrimination based on race, color, national origin, sex, age, or disability; enhances language assistance for individuals with limited English proficiency; and protects individuals with disabilities”, the agency said in a release.
Although the proposed rule only sought to clarify the prohibition on gender discrimination applies to gender identity, the final rule notes commenters sought to include non-binary identities within the scope of the definition of gender.
Several states in recent months have passed laws making it legal to discriminate against LGBTI people including North Carolina which is not allowing trans people to use bathrooms matching their gender identity.
The rule does not say insurers must provide coverage for gender-transition services, though insurers may have to answer questions if they deny coverage for medically necessary services related to gender transition, Modern Healthcare added.
“The final rule does not require covered entities to cover any particular procedure or treatment for transition-related care, including gender reassignment surgery”, a spokesperson for the Department of Health and Human Services told The Washington Free Beacon.
HHS noted that “none” of these religious organizations “asserted that there would be a religious basis for generally refusing to treat LGBT individuals”. By including gender identity in the regulations, they said, insurance and service providers would have to cover drugs, surgeries, and other services associated with some transgender people’s gender transitions.
Why do the transgender need such a centrally enacted law? While Section 1557 does not contain a blanket religious exemption, says the rule, “Claims under RFRA” would be examined on a “case-by-case basis”. “HHS supports prohibiting sexual orientation discrimination as a matter of policy and will continue to monitor legal developments on this issue”.
This includes discrimination based on pregnancy, gender identity and sex stereotyping.
The rule, originally proposed in September 2015, drew more than 2,000 letters during the comment period that ended last November 9, Modern Healthcare noted.
Discrimination has touched the lives of many LGBT people at all points in the healthcare system – from being unable to access insurance coverage, to outright refusals to provide care, to verbal and physical abuse at the hands of medical professionals. HRC noted then that it was concerned the rules did not adequately protect against sexual orientation discrimination.
Sepper also organized a group of law and religion scholars to counsel against exempting religious objectors from the ACA’s new sex discrimination requirements.
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The new rule came on the same day as the Education Department issued guidance to schools, telling that if they have sex-segregated activities and facilities, transgender students have to be able to participate according to their gender identity.
