MOVES TOWARD HEALTH EQUITY

The Health and Human Services Department in 2023 is set to restore an Obama-era rule under the Affordable Care Act prohibiting discrimination based on gender identity or sexual orientation. The department issued a draft regulation in July 2022, citing a 2020 Supreme Court case that ruled employers cannot fire workers for being gay or transgender.

Experts forecast clashes with states that recently passed laws seeking to ban gender-affirming care for minors.

“It’s something that’s going to bear out in the courts and will likely lack clarity. We’ll see differences in what different courts decide,” said Lindsey Dawson, associate director of HIV policy and director of LGBTQ health policy at the Kaiser Family Foundation. “The Supreme Court acknowledged that there was this tension. So it’s an important place to watch and understand better moving forward.”

The Centers for Medicare and Medicaid Services will continue rolling out a slate of health equity initiatives and quality measurements for providers and insurers serving marketplace, Medicare and Medicaid beneficiaries. The federal government announced in 2022 it would start measuring hospitals’ health equity performance this year. CMS is also adding new quality measures regarding maternal health, opioidrelated adverse events and screening for social needs and risk factors. The agency will distribute “birthing-friendly” designations to hospitals ranking highly on the Hospital Inpatient Quality Reporting Program’s maternal morbidity structural measure.

Accrediting bodies, such as the Joint Commission and National Committee for Quality Assurance, are joining the agency in establishing standards for health equity and data collection.

Medicaid plans are broadening benefits in 2023 to address social determinants of health and increase care coordination for high-risk patients. Democratic governors in states like North Carolina and Kansas have vowed to push for program expansion in Republican-controlled legislatures. ■