The Biden administration announced Friday that it had finalized an essential update to Section 1557 of the Affordable Care Act, significantly strengthening protections against discrimination in health care, especially for the LGBTQ+ community. This pivotal rule change reverses rollbacks under the Trump administration and establishes a benchmark for inclusivity in health care access. Photo: iStock
The Biden administration announced Friday that it had finalized an essential update to Section 1557 of the Affordable Care Act, significantly strengthening protections against discrimination in health care, especially for the LGBTQ+ community.
This pivotal rule change reverses rollbacks under the Trump administration and establishes a benchmark for inclusivity in health care access.
Advocacy groups have praised the move.
Lambda Legal counsel and health care strategist Omar Gonzalez-Pagan noted the significance of these restored protections.
“The rule released today restores critical regulatory nondiscrimination protections for those who need them most and ensures a legally proper reading of the Affordable Care Act’s health care non-discrimination law,” he said in a statement. “This marks a significant reversal of the harmful, discriminatory policies set by the previous administration.”
What is Section 1557?
Section 1557 of the Affordable Care Act is a critical nondiscrimination statute prohibiting discrimination based on race, color, national origin, sex, age, or disability in health programs or activities. It plays a vital role in ensuring equity within the health care system.
The definition of “sex” under this section has been subject to changes in interpretation, expanding, and contracting under various administrations.
What did the Trump-era rules change?
The Trump administration’s 2020 amendments redefined “sex discrimination” to exclude gender identity and sexual orientation, effectively removing explicit protections for transgender and nonbinary people under federal law.
This interpretation allowed health care providers and insurers to legally deny services based on an individual’s gender identity, significantly impeding access to necessary medical care for the LGBTQ+ community.
What is the rule change?
The Biden administration’s update to Section 1557 restores and expands protections that had been rescinded. It reaffirms that discrimination “on the basis of sex” includes sexual orientation and gender identity. This change not only counters previous setbacks but also explicitly incorporates protections against discrimination based on sex characteristics and sex stereotyping, crucial for intersex and transgender individuals, respectively.
The rule also strengthens protections for people with disabilities and those with limited English proficiency, ensuring more inclusive health care access.
It requires all health programs and activities that receive federal funding and health insurers to comply with these nondiscrimination requirements.
How does the rule affect LGBTQ+ people?
This rule change is a significant advancement for the LGBTQ+ community, particularly transgender patients, who often encounter discrimination in health care settings — from denial of routine care to refusals of critical gender-affirming treatments such as hormone therapies or surgeries.
The updated rule prohibits such discrimination under federal law, guaranteeing access to health care without fear of rejection due to gender identity.
Moreover, the rule mandates that services and coverage are provided without discrimination, including specific stipulations that insurance policies do not exclude care related to gender transition, addressing a prevalent barrier for transgender individuals in accessing necessary treatments.
This article originally appeared on Advocate.com, and is shared here as part of an LGBTQ+ community exchange between Q Voice News and Equal Pride.
