The Trump administration has removed protections from gender identity discrimination in the Affordable Care Act, leaving trans people more vulnerable to discrimination by health care providers and insurance policies.
The Obama administration originally added protections for trans people to Section 1557 of the ACA in 2016, which makes it illegal to discriminate due to “race, color, national origin, sex, age or disability in certain health programs and activities.” The added protections for trans people defined gender as “one’s internal sense of gender, which may be male, female, neither, or a combination of male and female.” However, these protections were immediately challenged in the courts.
The Trump administration proposed a new rule to define discrimination more narrowly in May 2019, removing gender-based protections in the ACA entirely. The rule was passed on Friday.
NBC News reports that in a statement, the Trump-led U.S. Department of Health and Human Services said that it would only recognize “sex discrimination according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.” The department also said it’s reverting to a time when the government “declined to recognize sexual orientation as a protected category under the ACA.”
This change means that health care providers and insurance policies regulated by the ACA can legally deny services to trans and non-binary people. It could also impact access to care for HIV-positive folks and the LGBTQ+ community in general.
Several LGBTQ+ advocacy organizations have criticized the move and are planning to challenge the new rule in court, including the Human Rights Campaign.
“We cannot and will not allow Donald Trump to continue attacking us,” Alphonso David, president of the Human Rights Campaign, said in a statement. “LGBTQ people get sick. LGBTQ people need health care. LGBTQ people should not live in fear that they cannot get the care they need simply because of who they are.”