As a community, trans and non-binary people have faced and overcome barriers to accessible health care services due to discrimination from insurers, providers, staff, and healthcare services. Here are a few examples from the 2015 U.S. Trans Survey.
One in four trans and non-binary people experienced a problem with their insurance, such as being denied coverage for care related to gender transition or being denied coverage for routine care because of their gender identity.
More than half of trans people who sought coverage for transition-related surgery were denied, and while a quarter were denied coverage for hormone affirming care.
One-third of those who saw a healthcare provider reported having at least one negative experience related to being transgender, with higher rates for people of color and people with disabilities. This included being refused treatment, verbally harassed, or physically or sexually assaulted, or having to teach the provider about transgender people to get appropriate care.
While there are protections on the federal level to prevent discrimination, more change is needed and we need your help.
The Biden-Harris Administration has opened an opportunity for the public to comment on a proposed regulation for the Affordable Care Act’s Health Care Rights Law. This will enable much needed changes to the interpretation of the rule so that the Administration can enforce trans people’s right to be protected from discrimination and harm while seeking health care services. Proposed regulations like this one don’t create new protections that weren’t already there or change the law, but they help educate people about their rights, and help insurance companies, health care providers, and government agencies understand how to follow the law.
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 discrimination in the basis of sex, including anti-transgender discrimination, by most health providers and insurance companies. It also prohibits discrimination based on race, national origin, age, and disability. Under the ACA, it is illegal for most insurance companies to have exclusions for transition-related care, and it is illegal for most health providers to discriminate against transgender people, for example, by turning someone away or refusing to treat them according to their gender identity.
Our rights to nondiscrimination protections were threatened and almost removed.
On June 12, 2020, the Trump administration released a final rule reinterpreting the Affordable Care Act’s non-discrimination provisions. Trump’s rule sets the view that the law does not 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.
We fought back with over 130,000 public comments
NCTE along with partner organizations initiated a campaign that led to over 130,000 comments to be submitted to the U.S. Department of Health & Human Services (HHS) condemning the proposal. This slowed down the rulemaking process and, on August 17th, 2020, one day before this rule change was going into effect, a Federal Judge blocked the rule based on the Bostock v. Clayton County Supreme Court decision.
...And then we elected pro-trans leaders
On May 5th, 2021, the Biden Administration and HHS announced that the Office for Civil Rights will interpret and enforce Section 1557 and Title IX’s nondiscrimination provisions to include sexual orientation and gender identity. The update was made in light of the U.S. Supreme Court’s decision in Bostock v. Clayton County and subsequent court decisions. And on January 4th, 2022, HHS announced they want to restore Obama-era protections and take a step further by recognizing gender-affirming care.
Make your voice heard
In just a few weeks, a new public comment period will be open, and you can make your voice heard by submitting a public comment about why it is important for transgender people to access health care without discrimination. Your comment can help ensure that trans people are represented in the rulemaking process. We know that our opposition does not want trans people to be protected, so we must all do our part to make sure our voices are louder.