Biden administration restores LGBTQ+ protections in health care

Under sweeping rules the U.S. Department of Health and Human Services finalized Friday, government health officials, organizations that receive federal health funding and health insurers that do business through government plans must meet the standards of non-discrimination. Officials stress that the rules are about prohibiting discrimination against patients rather than forcing providers to perform procedures.

Proponents of the rules have said they would protect patients from being turned away because they are gay or trans and ban health insurance policies that require LGBTQ+ people to wait longer and pay more for fertility benefits. The rules also contain provisions of broader application, such as requiring health care providers and other recipients of federal money to inform patients of free services that provide accessibility and language assistance.

Americans across the country now have a clear way to act on their anti-discrimination rights when they go to the doctor, talk to their health plan or participate in health programs managed by HHS, said the secretary of the HHS, Xavier Becerra, in a statement.

The rule focuses on Section 1557 of the Affordable Care Act, which prohibits health care providers from discriminating on the basis of race, color, national origin, sex, age, and disability in health programs that receive federal funding . HHS can apply strict penalties against organizations and workers that the agency concludes violated the law, ranging from requiring additional training to expelling offenders from federal programs. Federal officials say the rules preserve religious exemptions.

Politicians and advocacy groups have spent more than a decade arguing over how the White House should interpret the rule, particularly how it applies to LGBTQ+ and pregnant patients who could face discrimination from unwilling providers treat them The Obama administration issued regulations that included protections for gender identity and sexual stereotyping. The Trump administration removed those specific protections. And the Biden administration moved in 2022 to restore and expand the Obama-era definition to include sexual orientation as a specific protection.

The Supreme Court in 2020 also ruled, in Bostock v Clayton County, Ga., that sex discrimination includes discrimination based on gender identity or sexual orientation, prompting some courts to block implementation of the Trump-era rules. A coalition of LGBTQ+ organizations and others suing to repeal the Trump-era rules urged the Biden administration to fast-track the rules to restore protections.

LGBTQ+ activists encouraged the Biden administration to finalize the rules on Friday.

LGBTQ Americans are grateful for this step forward to fight discrimination in health care so that no one is denied life-saving treatment, Sarah Kate Ellis, president and CEO of the advocacy group GLAAD, said in a communicated

The fight over discrimination in health care is likely to drag on as conservatives have signaled plans to resist attempts to cement protections.

Republicans criticized the Biden administration’s proposed rule in 2022, and state attorneys general warned HHS not to exceed its statutory authority and indicated they were prepared to sue over the planned final rule.

Conservatives are also calling on a future Republican White House to reverse the redefinition of sex to cover gender identity and sexual orientation and pregnancy to cover abortion, wrote Project 2025, a conservative group backed by the Heritage Foundation. last year in a road map for policy makers.

The Biden administration’s interpretation of the law would create special privileges for new classes of people, defined in highly ideological and unscientific ways, Project 2025 added. The group called for HHS to focus on serious cases of racial discrimination, sex and disability, such as his investigation at Michigan State University into allegations that former gym doctor Larry Nassar assaulted students there.