Citing "ample evidence that there continues to be a persistent problem with discrimination in the health care industry" the Obama administration has
proposed new regulations to ban discrimination against trangender people.
The new protections are part of a much broader proposed regulation by the Department of Health and Human Services. In a first, the Affordable Care Act specified that sex discrimination is prohibited in health care, and the regulation carries that a step further, clarifying that "gender identity" is included within that protective umbrella.
"This is a huge step," said Michael Silverman, director of the Transgender Legal Defense and Education Fund in New York. "It covers a lot of ground." […]
The long-delayed rule amounts to a manual for carrying out the nondiscrimination section of President Barack Obama's health law, which prohibits bias in medical care on the basis of race, color, national origin, sex, age, or disability. Those underlying provisions already are in effect.
"Sadly, we have ample evidence that there continues to be a persistent problem with discrimination in the health care industry," said Jocelyn Samuels, head of the HHS office of civil rights, which would enforce the proposed rule. […]
"It is basically a requirement that insurers use nondiscriminatory criteria," Samuels told reporters.
The proposed rule will not require insurance companies to cover reassignment surgery or other transition treatments, but insurers and hospitals will have to cover and treat "medically necessary services related to gender transition by a man who identifies as a woman, or a woman who identifies as a man." The problem, advocates say, is not getting coverage for the transition treatments because they traditionally pay for hormone treatments and reconstructive surgeries—the problem has been getting care covered specifically for people going through transition.
There will be a public comment period on the proposed regulations lasting until November 6. There are other issues included—or not—in these regulations that still need work. For example, a difference section of the rule addressing discrimination in insurance benefits doesn't include a large loophole in prescription drug coverage that requires that certain people—cancer or AIDS or MS patients, for example—pay the majority of the cost of their prescriptions. Two organizations, the AIDS Institute and the American Cancer Society Cancer Action Network, told the AP that this regulation "was not specific enough, and the final version needs to provide examples of benefit designs that would be considered discriminatory."
