Obama administration seeks to ban transgender health care bias
The Obama administration said Thursday it wants to ban discrimination against transgender people in the health care system, a move that reflects an ever-brighter spotlight on “trans” issues in the U.S.
Part of long-awaited regulations released by the Department of Health and Human Services, the proposal builds on a part of Obamacare that for the first time banned health care discrimination based on sex.
The rules, if finalized later this year, would wrap gender identity into that prohibition.
While it would not force insurers to cover specific procedures such as sexchange surgery, it would bar them from denying medically necessary services to people who’ve gone through a gender transition.
For example, a doctor or hospital could not refuse treatment for ovarian cancer just because the patient identifies as a transgender man. Also, transgender patients could not be barred from using health facility restrooms that match their preferred gender identity.
“The proposed HHS rule is an enormous milestone for all transgender and gender nonconforming people in the U.S. access to safe, respectful health care [as] a basic human right, and this policy makes a huge advance toward equity in health care for transgender people,” said Kris Hayashi, executive director of the Transgender Law Center.
The proposed rules also require hospitals and other providers to provide notice that assistance is available to people with limited English proficiency or disabilities.
The regulation would apply to insurers, hospitals and providers that receive federal funds on Obamacare’s health exchanges or through other public programs, such as Medicare.
“This proposed rule is an important step to strengthen protections for people who have often been subject to discrimination in our health care system,” Health and Human Services Secretary Sylvia Mathews Burwell said. “This is another example of this administration’s commitment to giving every American access to the health care they deserve.”
HHS released its proposal amid notable developments in the “trans movement.” Former Olympic gold medalist Bruce Jenner received wall-to-wall coverage through magazine covers and his own reality TV show after he transformed himself into “Caitlyn,” and the Obama administration last month hired the first openly transgender official in White House history.
The National Center for Transgender Equality said the regulation, if finalized, “could result in one of the biggest wins of this administration.”
Reaction from other interest groups was largely positive, although The AIDS Institute said HHS could go further to crack down on insurers that put every medication for certain conditions on the highest-cost tier, do not cover the medications at all or force patients to pay to much out of their own pockets.
HHS is requesting feedback through Nov. 6 on the proposal. In particular, it wants to know if new religious exemptions are needed in light of the new prohibitions.
Already Obamacare’s birth control rules on employers kicked off a longrunning court saga, after devout corporate owners and faith-based nonprofits complained that mandated coverage of certain types of contraceptives violated their religious beliefs.
The administration has tried to accommodate the nonprofits and closely held corporations who beat back the mandate before the Supreme Court last year, although many in the nonprofit camp want a blanket exemption from the rule.
Thursday’s proposal says HHS does not plan to roll back existing religious exemptions or conscience protections for health care providers.
“The proposed HHS rule is an enormous
milestone for all transgender and gender nonconforming people in the U.S. access to safe, respectful health care [as] a basic human right.” — Kris Hayashi, executive director
of the Transgender Law Center