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HHS confirms ban on healthcare and insurance bias against LGBT People
From press releases
2016-05-13

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( May 13, 2016, New York, NY ) — The United States Department of Health and Human Services ( HHS ) today finalized new rules confirming that lesbian, gay, bisexual and transgender ( LGBT ) people are protected against health care discrimination under Section 1557 of the Affordable Care Act. Section 1557 prohibits discrimination on the basis of sex in health care services and programs receiving federal funding. The new rules confirm that individuals cannot be denied health care or health insurance coverage based on their sex, including their gender identity or nonconformity with sex stereotypes, including the stereotype that all people are, or should be, heterosexual or the sex of the person with whom the individual is in a relationship.

Lambda Legal, the American Civil Liberties Union ( ACLU ), GLBTQ Legal Advocates & Defenders and the National Center for Lesbian Rights issued the following statement in response to today's announcement. In addition, Lambda Legal and the ACLU are joining the Center for American Progress ( CAP ) for a media teleconference today on the new regulations. Details below:

"We commend HHS for issuing these regulations, the product of several years of research, careful review, and inclusive consideration. These rules will dramatically improve the public health landscape for LGBT populations that suffer persistent health disparities due to pervasive bias and discrimination in health care settings and insurance coverage. Also importantly, the regulations do not include any new religious exemption to their implementation.

"Transgender people, in particular, have faced extreme mistreatment for far too long. These new rules will save lives by clarifying that discrimination based on gender identity is unlawful sex discrimination. Under these rules, categorical exclusions of gender transition-related care are impermissible, and individuals must be afforded access to facilities and programs consistent with their gender identity.

"The rules also recognize that discrimination based on sex stereotypes or the sex of someone's partner or spouse is unlawful sex discrimination. As numerous federal courts have held, federal civil rights laws protect LGBT people against mistreatment based on sex stereotypes, including discrimination based on lesbian, gay, or bisexual identity.

"Our organizations have an extensive track record representing LGBT people who have experienced discrimination in health care services and insurance, and are continuing to do so today. The new Section 1557 rule is an important marker of civil rights and public health progress, and we anticipate vigorous enforcement efforts aimed at ending all unlawful discrimination in health care settings."

Details for the Lambda Legal, ACLU and CAP media teleconference are: [it already happened -rw] ...

... The new Section 1557 regulations are here: www.lambdalegal.org/in-court/legal-docs/20160513_hhs-section-1557-nondiscrimination-in-health-programs-and-activities-final-rule .

Task Force Statement on Guidance on Section 1557 of the Affordable Care Act

Washington, DC, May 13, 2016 — Today the Obama Administration issued guidance on Section 1557 of the Affordable Care Act, clarifying that discrimination against lesbian, gay, bisexual, and transgender people in a health care setting violates federal law. The new guidance does not broaden existing religious exemptions.

"In essence, the new guidance clarifies that discrimination against lesbian, gay, bisexual, and transgender people is prohibited in health care settings, including clinics, hospitals, mental health facilities, and doctor's offices. While sexual orientation is not explicitly included in the rule, as courts clarify the legal basis for sexual orientation protections, we expect HHS to provide updated clarification as well. And of course the HHS will accept complaints on the basis of sex discrimination from lesbian, gay, bisexual, and transgender people," said Meghan Maury, Senior Policy Counsel, Criminal and Economic Justice Project Director.

Access to quality affordable health care for transgender people was an important issue in the National LGBTQ Task Force's ground-breaking study "Injustice at Every Turn." The report indicated that respondents faced serious hurdles to accessing health care, including:

— Refusal of care: 19% reported being refused care due to their transgender or gender non-conforming status, with even higher numbers among people of color.

— Harassment and violence in medical settings: 28% of respondents were subjected to harassment in medical settings and 2% were victims of violence in doctor's offices.

— Lack of provider knowledge: 50% reported having to teach their medical providers about transgender care.

With the ongoing manipulation of faith as an excuse to discriminate in states across the nation, another important aspect of the new guidance is that it does not contain a religious exemption—thanks to the successful advocacy of the National LGBTQ Task Force and its partners. This means that religious organizations may not seek a blanket exemption when a nondiscrimination obligation conflicts with religious belief. However, existing religious exemptions will continue to create barriers for many members of the LGBTQ community when seeking the provision of unbiased comprehensive reproductive health care.

HRC response

WASHINGTON — Today, the Human Rights Campaign (HRC) praised the Department of Health and Human Services (HHS) Office for Civil Rights for implementing a regulation that provides explicit protections from discrimination on the basis of gender identity and sex stereotyping, including for lesbian, gay, and bisexual people, in healthcare and insurance under the provisions of Section 1557 of the Affordable Care Act (ACA).

"Access to healthcare should never be denied because of your sexual orientation or gender identity," said HRC President Chad Griffin. "LGBT people have too often faced healthcare systems that provide inequitable and hostile treatment. This new and important regulation will address many of these disparities and is critical to help end discrimination against transgender and gender nonconforming people in healthcare and insurance. The Affordable Care Act has made a tremendous impact on the lives of millions of Americans, and this regulation makes clear that LGBT people and their unique needs are included in the protections it provides."

HRC has repeatedly called on the Administration to implement these essential protections. In November of last year, HRC staff delivered 13,398 public comments from our members and supporters in response to the proposed rule change.

Discrimination has touched the lives of many LGBT people at all points in the healthcare system — from being unable to access insurance coverage, to outright refusals to provide care, to verbal and physical abuse at the hands of medical professionals.

This new regulation makes clear that transgender people must be treated consistent with their gender identity and cannot be denied care provided to anybody else, even when it's transition-related care. We are disappointed that the regulation does not provide sufficient clarity around discrimination on the basis of sexual orientation. However, prohibitions on discrimination resulting from sex-stereotyping will provide significant protections for lesbian, gay, and bisexual people. Any individual who has experienced discrimination on the basis of sexual orientation or gender identity in the provision of health care or insurance should file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.


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