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New Trump Proposal Could Limit Health Care Access for Two Million Transgender Americans

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Ash Orr (they/he)

In an escalation of its dangerous attacks against transgender people, the Trump-Pence administration today proposed regulations falsely telling health care providers and insurers they can legally discriminate against transgender people.

Contradicting federal law and two decades of court rulings, this proposed regulation will put up more unnecessary barriers between two million transgender people in the US and the health care and insurance coverage they need.

At issue is Section 1557 of the Affordable Care Act, which prohibits sex discrimination in health care. Known as the Health Care Rights Law, the rule was the subject of a regulation published by the Obama administration in 2016 that confirmed transgender people were protected by the law’s provisions prohibiting discrimination from providers and insurers. This regulation has helped doctors, hospitals, and insurance companies to update policies, train staff, and eliminate coverage exclusions for transition-related care.

The new regulation proposed today, however,  would eliminate all recognition by the Department of Health and Human Services of protections for transgender people under the Health Care Rights Law, erasing the progress made in ensuring the rights of all transgender people to equal and fair treatment. It also seeks to weaken civil rights protections for patients more broadly in a variety of ways by limiting how broadly HHS will enforce the law.

Mara Keisling, Executive Director for the National Center for Transgender Equality, said the following:

Predicated on little more than prejudice, this proposal will abandon 2 million Americans who already face significant barriers to accessing adequate and life-saving health care. This is not about free health care or special treatment. It’s about the right of every American to be treated with dignity when they walk into an emergency room, meet a new doctor, or find the right insurance plan. If permitted, this rule will promote ignorance and hate that no American should have to face while seeking care, and we are ready to fight it with everything we’ve got.

Kris Hayashi, Executive Director for Transgender Law Center, said:

This proposed rule is yet another outright attack from the Trump administration on the health, well-being, and survival of transgender people. Everyone should be able to go to the doctor when we need help without being turned away or denied treatment because of who we are. That’s what the law says, yet in practice many transgender people still face devastating discrimination in health care. This rule dangerously encourages illegal discrimination, putting the lives of transgender people in jeopardy – particularly for trans people living with HIV, Black transgender people and people of color, trans people with disabilities, and rural and Southern trans folks.

The proposed rule will now go through a 60-day public comment period—similar to two previous public comment periods on the original rule in 2013 and 2015, which produced nearly 25,000 comments overwhelmingly supporting the recognition of transgender protections. HHS public comment periods in 2017 and 2018 also produced hundreds of thousands of public comments opposing anti-transgender proposals. If a final rule issued in the coming months is similar to today’s proposal, it is certain to draw legal challenges similar to President Trump’s ban on transgender military service members.

The National Center for Transgender Equality and the Transgender Law Center urge health care providers and insurers to continue following the law as it has been interpreted by courts around the country, and to make their voices heard in support of equal access to health care.

For more information, visit the Protect Trans Health website.

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