In the midst of changing attitudes regarding gender identity and sexuality, including gender transitioning and same-sex marriages, the Obama administration has proposed new regulations for the Affordable Care Act (ACA) to include gender identity under the umbrella banning sex discrimination in healthcare.
The rules clarify the standards that the Department of Health and Human Services (HHS) would apply in enforcing the protections found in Section 1557, which prohibits discrimination on the ground of race, color, national origin, sex, age, or disability. Under the proposed rules, Section 1557 also applies to the health insurance marketplace and health programs administered by HHS. Section 1557 is the first federal civil rights law to prohibit discrimination on the basis of sex in healthcare.
"The proposed rule applies to every health program or activity that receives HHS funding, every health program or activity administered by HHS, such as the Indian Health Service or the Medicare program, and every health program or activity administered by an entity created by Title I of the ACA,” explains National Center for Lesbian Rights (NCLR) policy director Julie Gonen. “These rules will have a profound effect on the health and very lives of LGBT Americans. We can now see a day in the very near future when transgender people can get coverage for the medically necessary care that they need but for which they are too often denied health insurance coverage.”
Examples of covered entities include hospitals, health clinics, health insurance programs, state Medicaid agencies, community health centers, physician practices, home healthcare agencies, and the health insurance marketplaces. Both the federally-facilitated marketplaces and the state-based marketplaces are covered by Section 1557. Thus, if a managed care company or insurer offers plans through Medicare or on the exchanges, all of its plans, including those in the private market, are covered by the Section 1557 regulations.