HHS proposes stronger ACA protection of transgender rights

The aim is to strengthen civil rights protections that bar medical providers and insurers from discriminating based on gender, whether in treatments or access to facilities and services.

By Stephen Feller

WASHINGTON, Sept. 4 (UPI) -- The U.S. Department of Health and Human Services has proposed a rule to codify protection for transgender people under the Affordable Care Act, which already bans sex discrimination in health programs and activities.

While the ACA already outlaws discrimination, the rule is meant to specifically address concerns about the health insurance marketplaces, as well as health programs and activities. The proposed new rule also includes requirements for effective communication for individuals with disabilities and enhanced language assistance for people with limited English proficiency.


"This proposed rule is an important step to strengthen protections for people who have often been subject to discrimination in our health care system," said HHA Secretary Sylvia Burwell, in a press release.

Currently, section 1557 of the ACA bans sexual discrimination. The agency already is required to enforce civil rights laws on the basis of race, color, national origin, disability or age.

Under the new rule, insurance companies will be required not to discriminate based on gender identity and must be treated consistent with their identity, including in access to facilities. Specifically, the rule says that healthcare cannot be denied or services limited because the patient identify as another gender -- for example, a person seeking treatment for ovarian cancer cannot be turned down for treatment because they identify as male.


The rule also requires that gender transition care be evaluated on a case-by-case basis, explicitly outlawing categorical exclusions for gender transition.

Requirements for women are strengthened under the new rule as well, specifically prohibiting women from being charged more for health coverage than men.

The rule also includes requirements for communication, both with people with limited English proficiency and for people with disabilities. In both cases, methods of communication, from alternative formats to interpreters and written materials, should be offered in order to better explain care and treatment to patients.

The proposed rule, Nondiscrimination in Health Programs and Activities, is open for public comment until November 6.

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