As a community, trans and non-binary people continue to face barriers to accessible health care services due to discrimination from insurers, providers, staff, and healthcare services. As we learned from the 2015 U.S. Trans Survey:

  • One in four trans and non-binary people has experienced a problem with their insurance, such as being denied coverage for care related to gender transition or being denied coverage for routine care because of their gender identity.
  • More than half of trans people who sought coverage for transition-related surgery were denied, and a quarter were denied coverage for hormone-affirming care (commonly referred to as HRT).
  • One-third of those who saw a healthcare provider reported at least one negative experience related to being transgender, with higher rates for people of color and people with disabilities. This included being refused treatment, verbally harassed, or physically or sexually assaulted, or having to teach the provider about their identity and experiences to get appropriate care.

While there are some protections on the federal level to prevent discrimination, more change is needed and we need your help to make it happen.

Right now, the Biden-Harris Administration needs to hear from the public on a proposed regulation for the Affordable Care Act’s Health Care Rights Law. This regulation has the potential to ensure that the Administration can enforce trans people’s right to be protected from discrimination and harm while seeking health care services. Proposed regulations like this one don’t create new protections that weren’t already there or change the law, but they clarify the law’s intent, educate people about their rights, and help insurance companies, health care providers, and government agencies understand how to follow the law.

What is the Health Care Rights Law?

The Health Care Rights Law, also known as Section 1557, is the part of the Affordable Care Act (ACA) that:

  • requires providers and insurers receiving federal funds not to deny or restrict access to health care based on sex, including gender identity and sexual orientation;
  • prohibits health providers and insurance companies receiving federal funds from discriminating on the basis of sex, including anti-transgender discrimination; and
  • further prohibits discrimination based on race, national origin, age, and disability.

Thanks to this law, it is illegal for most insurance companies in the United States to completely exclude transition-related care, and it is illegal for most health providers to discriminate against transgender people, for example, by turning someone away or refusing to treat them according to their gender identity.

We Nearly Had These Rights Taken Away.

On June 12th, 2020, the Trump administration released a final rule reinterpreting the Affordable Care Act’s non-discrimination provisions. Trump’s rule interpreted the law as not protecting patients from discrimination because they are transgender, pregnant, or have a same-sex partner or family member. It also instructed hospitals and insurance companies that they were no longer required to provide patients with notices of their rights or even how to get information in different languages.

We fought back with over 130,000 public comments!

NCTE along with partner organizations initiated a campaign that led to over 130,000 comments to be submitted to the U.S. Department of Health & Human Services (HHS) condemning the proposal. This slowed down the rulemaking process and, on August 17th, 2020, one day before this rule change was going into effect, a Federal Judge blocked it based on the Bostock v. Clayton County Supreme Court decision!

…And then we elected pro-trans leaders

On May 5th, 2021, the Biden-Harris Administration and HHS announced that the Office for Civil Rights will interpret and enforce Section 1557 and Title IX’s nondiscrimination provisions to include sexual orientation and gender identity. The update was made in light of the U.S. Supreme Court’s decision in Bostock v. Clayton County and subsequent court decisions. And on January 4th, 2022, HHS announced they want to restore Obama-era protections and take a step further by recognizing gender-affirming care.

Experts Agree

These respected organizations stand behind the nondiscrimination protections in the Affordable Care Act (Section 1557).

Protect Trans Health is a collaboration between: