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Government Proposal Seeks to Remove Health-Care Bias Against Transgender People

New rules would carry out anti-bias provisions of Affordable Care Act

Mirroring a shift in society, the Obama administration proposes to ban discrimination against transgender people throughout the U.S. health care system, according to the Associated Press.

Once the proposed regulations are final, they will expand insurance coverage for gender transition and prohibit health care facilities from denying transgender people access to restrooms that match their individual gender identity.

The new protections are part of a broader rule from the Department of Health and Human Services to carry out anti-bias provisions of the Patient Protection and Affordable Care Act (PPACA). The PPACA specified that sex discrimination is prohibited in health care, and the new regulation carries that a step further, clarifying that “gender identity" is included under that protective umbrella.

The long-delayed rule amounts to a manual for carrying out the PPACA’s prohibition against medical discrimination on the basis of race, color, national origin, sex, age, or disability. Those underlying provisions already are in effect.

Jocelyn Samuels, head of the HHS Office for Civil Rights, said the rule does not explicitly require insurers to cover gender transition treatment, including surgery. But insurers could face questions if they deny medically necessary services related to gender transition by a man who identifies as a woman, or by a woman who identifies as a man.

“It is basically a requirement that insurers use nondiscriminatory criteria,” Samuels told reporters.

Insurers already pay for services such as hormone treatments and reconstructive surgery, but decline to cover them when they’re part of a gender transition.

The new requirements would affect the entire health care system because service providers who accept federal dollars would have to comply.

The regulation may not be final for many months. The public comment period extends through November 6, and officials are seeking comment on a range of issues, including religious conscience protections for service providers and whether sexual orientation should also be protected.

Source: Associated Press; September 3, 2015

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