On Friday, June 12, 2020, the Department of Health and Human Services (HHS) released a rule change to Section 1557 of the Affordable Care Act (ACA) to eliminate all protections from discrimination for transgender and non-binary people by changing the definition of gender to a “binary of male and female”. Previously, the ACA had ensured protection from discrimination based on “an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female”. This explicitly discriminatory rule change was published despite the more than 120,000 comments HHS received from concerned Americans in 2019 and protests against the rule change in 2020. This change is significant because it potentially reduces access to medical care for the hundreds of thousands Americans who identify as transgender.
Doctors for Change stands with the LGBTQIA+ community in its opposition to this rule change. This action raises barriers to care between the physician and the patient.
Further, the rule change also strives to remove patient protections on the grounds of “conscience and religious freedom”, sanctioning discrimination and denial of access to care because a provider or insurer may disagree with a person’s legally protected right to terminate a pregnancy or a transgender man’s right to a mastectomy. In addition, we oppose changes to Section 1557 which eliminate protections for patients with disabilities, limited English Language Proficiency, processes for filing grievances, and protections against intimidation. The trust between provider and patient is critical to ensuring quality care and good health. Breaking that trust is detrimental to the public’s health and goals against a physician’s oath to “do no harm.”
We join with LBGTQIA+ advocates, including the American Civil Liberties Union, Human Rights Campaign, Lambda Legal, and health providers organizations; including the American Medical Association and American Academy of Pediatrics in their efforts to ensure the public understands what this rule change aims to inflict on transgender and non-binary people in the United States. To clarify, HHS does not have the authority to contradict the ACA statute and attempt to legalize discrimination. Moreover, the Supreme Court has just today ruled that LGBTQIA+ employment rights are protected by Federal anti-discrimination laws.
We call on the Texas Congressional Delegation to join us in advocating for the right to health care of all Texans and that the dignity of every person be protected and honored. Further, we call on Congress to pass the Equality Act and we call on state leaders in Texas to, at last, enact similar legislation during the 2021Texas Legislative session.
At a moment when our country is grappling deeply with a long history of systemic oppression of Black Americans, in the midst of the worst global infectious disease pandemic in a century, during Pride Month, the notion that HHS would sanction discrimination and attempt to limit access to health care is unacceptable.
What health care providers can do NOW in response to the rule change:
- Contact your member of congress and ask them to pass the Equality Act
- Contact your state representatives and ask them to pass a statewide non-discrimination act in the 2021 Texas Legislative Session
- Contact your local representatives and ask them to pass a local non-discrimination act
- Does your healthcare practice have a non-discrimination policy that is inclusive of the LGBTQIA+ community? If not, advocate for change.
- Join Doctors for Change doctorsforchange.org