The Trump administration is moving to ax Obama-era protections for transgender people in healthcare.
On Friday, the Department of Health and Human Services announced a proposal to redefine the Affordable Care Act’s (ACA) 1557 anti-discrimination protections which would remove “gender identity,” effectively gutting transgender protections. The regulation also takes aim at reproductive health, explicitly stating that healthcare providers aren’t required to perform or pay for abortions.
While the ACA bars discrimination on the basis of sex, age, race, color, origin and disability, its 1157 guidelines specifically clarified that “sex discrimination” included “gender identity,” a critical point for ensuring transgender coverage by doctors and insurance companies.
The National Center for Transgender Equality (NCTE) says the move could limit healthcare for 2 million transgender Americans already facing steep hurdles in accessing medical care.
“It’s about the right of every American to be treated with dignity when they walk into an emergency room, meet a new doctor, or find the right insurance plan,” said NCTE Executive Director Mara Keisling. “If permitted, this rule will promote ignorance and hate that no American should have to face while seeking care, and we are ready to fight it with everything we’ve got.”
Kris Hayashi, executive director for Transgender Law Center called the announcement an “outright attack” on the survival of transgender people.
“Everyone should be able to go to the doctor when we need help without being turned away or denied treatment because of who we are,” Hayashi said in a statement. “This rule dangerously encourages illegal discrimination, putting the lives of transgender people in jeopardy – particularly for trans people living with HIV, Black transgender people and people of color, trans people with disabilities, and rural and Southern trans folks.”
It’s the second major blow to trans people in just three days by the Administration. On Wednesday, the Department of Housing and Urban Development announced plans to roll back anti-discrimination protections for trans people at its more than 6,700 government-funded shelter programs.
The proposed rule also comes on the heels of new “conscience protections” issued in earlier this month, which shield healthcare workers who refuse to treat transgender patients or perform abortions.
In a statement to media, New York City Anti-Violence Project Director of Communications Eliel Cruz said the healthcare rollback would further expose an already vulnerable population to more violence. He cited three transgender homicides in the past week.
“This is yet another attempt by this administration to enshrine discrimination into our laws and will ultimately put millions of people in danger,” said Cruz in a statement.
In a statement, HHS Office of Civil Rights Director Roger Severino argued that the proposal conforms to current law because the protections have been blocked by a court injunction. In 2016, the 1157 protections were halted by a conservative judge in Texas who ruled that civil rights legislation didn’t protect transgender people.
“The American people want vigorous protection of civil rights and faithfulness to the text of the laws passed by their representatives,” said Severino. “The proposed rule would accomplish both goals.”
While the protections had been blocked, their rollback, in combination with the administration’s move to shield physicians who object to treating transgender patients, is seen as a perfect storm in an overall campaign to undermine transgender healthcare access.
LGBTQ advocates have characterized the “conscience rules” and the 1557 roll back as a kind of one-two punch.
Stacey Long Simmons, director of the Advocacy and Action Department at the National LGBTQ Task Force, vowed that LGBTQ groups would fight both moves.
“Having just issued a so-called ‘conscience rule’ to allow religious beliefs to justify denying services, now the administration is attempting to strip away much-needed nondiscrimination protections for LGBTQ people, those living with disabilities, people seeking abortion services, and those with limited English proficiency,” said Simmons in a statement.
