HHS finalizes rule to improve health equity under the Affordable Care Act
The Department of Health and Human Services (HHS) today issued its long-awaited final rule to address discrimination in health care, advance health equity, and reduce health care disparities. Under the rule, which implements the anti-discrimination provision of the Affordable Care Act, individuals are protected against discrimination in health care and health insurance on the basis of race, color, national origin, age, disability and sex.
The new rules make it clear that sex discrimination includes discrimination based on pregnancy, gender identity and sex stereotyping. There are many parts to the rule, and we and others will have much more to say soon – but a few points of particular importance to the LGBT community are:
Individuals cannot be denied health care or health coverage based on their sex, including their gender identity and sex stereotyping.
Categorical coverage exclusions or limitations for all health care services related to gender transition are discriminatory.”
While the rule does not resolve whether sexual orientation discrimination is sex discrimination, it plainly states that claims will be reviewed for sex stereotyping, and commits HHS to continuing to monitor developments in this area.
Providers are required to post a notice of consumer rights, increasing patients’ awareness of, and making it more likely that they will assert, those rights.
There will undoubtedly be disputes over the precise coverage and scope of what this all means. But there is no question that this rule is a significant advance for LGBT people, who have historically been denied access to care, and especially to the many transgender individuals who have been unable to access medically necessary care because of blanket exclusions of coverage.