The Biden administration has recently announced a new federal rule aimed at strengthening civil rights protections for transgender and other LGBTQ individuals. This rule, introduced by the Department of Health and Human Services (HHS), overturns a Trump-era regulation that had weakened discrimination protections based on gender identity and sexual orientation under Section 1557 of the Affordable Care Act (ACA).
Section 1557 prohibits discrimination on the basis of various factors by entities that primarily provide health care and receive federal funding. This includes discrimination based on race, color, national origin, sex, age, or disability. The rule is enforced by the HHS Office for Civil Rights.
HHS Secretary Xavier Becerra stated that the new rule provides Americans with a clear way to address discrimination when seeking healthcare services or engaging with health programs overseen by HHS. The rule comes at a time when more than 20 states have imposed restrictions on or banned gender-affirming care for children. In addition, more than a dozen states are currently facing lawsuits over their policies regarding youth gender affirming care. The rule aligns with the US Supreme Court’s 2020 decision in Bostock v. Clayton County, which determined that LGBTQ individuals are protected from discrimination under Title VII of the Civil Rights Act of 1964.
In response to the Bostock decision, the Biden administration announced in 2021 that it would interpret the word “sex” in the ACA to include gender identity. The new rule will be enforced for health insurance plans operating through Medicare, Medicaid, or the Obamacare exchanges, including care provided under Medicare Part B, such as services offered in a doctor’s office.