The Trump administration is attempting to roll back protections for transgender and gender non-conforming individuals who were previously protected from discrimination under the Affordable Care Act (ACA). On June 14th, the US Department of Health and Human Services (HHS) published a proposed regulatory change to the ACA Section 1557, the nondiscrimination provision of the ACA.

Under the Obama administration, Section 1557 defined sex discrimination to include discrimination on the basis of sex stereotyping, gender identity, and termination of pregnancy. Any discrimination against transgender individuals due to their identity would therefore violate the nondiscrimination provisions of the ACA.

The new proposed rule would revise the “basis of sex” to strictly adhere to a previous interpretation that only includes “male” or “female” – as assigned at birth.

Such a revision could allow health care providers to refuse to serve individuals who are transgender or who do not conform to traditional sex stereotypes. The new rule would also allow health plans to exclude or limit coverage for any health services related to gender transition.

Section 1557 was originally enhanced to extend protections to LGBT elders and the current administration is clearly attempting to reverse this progress.

The rule change would also strengthen the ability of healthcare providers to refuse abortion on the basis of religious objection, weaken the standards for language assistance services for individuals with limited English proficiency, and make it easier for health insurers to deny, cancel, or limit coverage due to a person’s race, color, national origin, sex, age, or disability.

Until August 13th, HHS will receive any and all comments regarding this proposal, which will also be displayed publicly. We must urgently inform HHS that this revision will critically hinder transgender and gender non-conforming elders’ opportunity for care.

Comments can be made online. To begin the process of adding a comment, click the blue “Comment Now!” button on the right side of the webpage. You will then be prompted to type your comment in a large text box along with your name in the text boxes below.

Public comments can also be submitted by mail to U.S. Department of Health and Human Services, Office for Civil Rights, Attention: Section 1557 NPRM, RIN 0945-AA11, Hubert H. Humphrey Building, Room 509F, 200 Independence Avenue, SW, Washington, DC 20201.