You Still Have Non-Discrimination Rights in Health Care!

A lot has happened in 2020. Much of it has been unpredictable-- to say the least. And while the Trump administration’s new rule attempting to undermine Section 1557 under the Affordable Care Act was expected, no one could have expected the global health crisis that is devastating the public health of our community. Now more than ever, we must know our rights so that we can get accessible and high-quality health care that we deserve.

What is the Health Care Rights Law?

The Health Care Rights Law, also known as Section 1557, is the part of the Affordable Care Act (ACA) that prohibits sex discrimination, including anti-transgender discrimination, by most health providers and insurance companies, as well as discrimination based on race, national origin, age, and disability. Under the ACA, it is illegal for most insurance companies to have exclusions of transition-related care, and it is illegal for most health providers to discriminate against transgender people, like by turning someone away or refusing to treat them according to their gender identity.

On June 12th,  the administration released a final rule reinterpreting the Affordable Care Act’s non-discrimination provisions. The new rule sets the Trump administration’s view that the law doesn’t protect patients from discrimination because they are transgender, pregnant, or have a same-sex partner or family member. It also instructs hospitals and insurance companies that they are no longer required to provide patients with notices of their rights or how to get information in different languages.

Am I still protected under the law?

Yes! While the Trump administration has enacted this new rule that misinterprets​ explicit protections for transgender people in health care by excluding protections from discrimination based on gender identity, you still have rights. It is important to know the following:

• You are still protected under Section 1557. The ACA is a law passed by Congress that is still fully in force, and it says that sex discrimination in a health care setting or in an insurance plan is unlawful.
• This rollback is not in accordance with how courts have repeatedly interpreted Section 1557, namely that discrimination against transgender people in health care settings is unlawful under Section 1557.
• There will be multiple lawsuits challenging this repeal.
• This repeal may embolden certain people to harass or deny care, but such conduct is still illegal. You should continue to report discrimination in health care and seek legal assistance if you experience discrimination.

What can I do to help?

You can urge health insurance companies to do the right thing, regardless of what the Trump administration says. We’re starting with the country’s largest, UnitedHealthcare. Ask them to commit to the following to ensure transgender people can safely access care:

1. Do NOT take any steps to reduce coverage or services in response to this rule.

2. Explicitly prohibit gender identity discrimination in your non-discrimination policies. 

3. Continue to provide individuals with full notices of their non-discrimination rights.

We have supporters on our side. 

• Blue Cross Blue Shield: BCBS Association Statement on the Administration’s Final Rule to Remove Discrimination Protections
• American Health Insurance Plans: AHIP Responds to Final Rule Seeking to Eliminate Nondiscrimination Protections in Health Care
• Wisconsin: Wisconsin Insurance Commissioner Says Health Insurance Discrimination on the Basis of Gender Identity is Illegal
• New York: Superintendent Linda A. Lacewell Announces Action to Protect LGBTQ New Yorkers against Bias in Healthcare
• Connecticut: Insurance Commissioner: Connecticut LGBTQ health care consumers remain protected from discrimination
• Illinois: Guidance Relating to Nondiscrimination in Healthcare Services in Illinois
• New Mexico: NM Superintendent of Insurance Committed To Protecting Civil Rights in Health Care
• Vermont: Michael S. Pieciak: On LGBTQ+ rights: Vermont and U.S. Supreme Court lead
• Washington: Kreidler directs health insurers in Washington state to protect transgender patients

Resources

• For more information on your health care rights, please visit our page.
• Know your rights under Medicare
• FAQ about Veterans Health Administration for trans veterans
• If you are experiencing discrimination, please visit TLDEF’s Trans Health Project.