You Can Help Beat the Next Threat to Trans Health Care
Last week was a hard-won victory for the whole nation: Senators Susan Collins, Lisa Murkowski, and John McCain joined Democrats in voting to defeat the most recent Affordable Care Act (a.k.a. Obamacare) repeal attempt — and this appears to be the last repeal effort for the foreseeable future.
For months, people across the country, including so many trans people and our loved ones, called, marched, sat in, and did everything possible to stop this terrible legislation. We saved health insurance coverage for millions, kept protections for people with preexisting conditions, and ensured that people can still access Planned Parenthood’s lifesaving services.
Critically, we avoided the disastrous effects that ACA repeal would have had on trans people. Amid so many attacks on trans people and other marginalized communities, stopping the ACA repeal is truly a testament to the power of resistance.
But we’re not out of the woods yet. Trans people are still facing a very serious threat to health care. That’s because the Trump administration is poised to repeal a historic regulation that ensures trans people are treated fairly when trying to get health care. NCTE and the entire civil rights community worked for six years to put through this regulation, which enforces a non-discrimination law known as Section 1557.
What is Section 1557?
Section 1557 is a part of the Affordable Care Act that prohibits discrimination in health care based on gender, race, national origin, age, and disability. The regulation implementing Section 1557 makes clear that this means trans people are protected from discrimination when seeking health care and insurance companies can’t place blanket bans on transition-related care. It also clarifies protections for non-English speakers, disabled people, and other marginalized groups.
Thanks to the regulation enforcing Section 1557, health care plans around the country eliminated discriminatory exclusions for transition-related care in 2017. We’ve seen this progress across individual and corporate plans, city and state employee plans, and in a growing number of state Medicaid plans as well.
On top of that, the regulation helps us push health care providers and systems to change policies and practices that discriminate against trans people. For example, California mom Katharine Prescott is using Section 1557 to sue a hospital where her trans son was harassed and humiliated by staff.
What is HHS planning?
In June, the Department of Health and Human Services (HHS) asked the public to suggest what health care regulations they should get rid of. By doing so, they were setting the stage to justify rollbacks of all kinds of health-related protections. In response, NCTE and many other organizations sent comments outlining why we need to keep the Section 1557 regulation. Anti-LGBT groups also wrote in urging HHS to roll it back.
Repealing the regulation would not change the meaning of Section 1557 itself, but it would send a false and dangerous message that trans people can be turned away.
In recent months we’ve seen other signs of just how serious the Trump administration is about undermining equality when it comes to health care. In response to a lawsuit by anti-LGBT groups challenging Section 1557’s protections for trans people, the Trump administration didn’t defend the law but instead asked a judge to put the lawsuit on hold because they intend to roll back that regulation. The judge agreed.
We want to emphasize that repealing the regulation implementing Section 1557 would not change the meaning of Section 1557 itself. Trans people who faced discrimination by a hospital or health plan could still sue in court with or without that regulation. But it would likely lead to a lot more discrimination. Just like when the Trump Administration rolled back lifesaving guidance on the rights of trans students, it would send a false and dangerous message that trans people can be turned away.
What can we do about it?
It could be months or just weeks before HHS takes the next step and formally proposes that rollback. If that happens, we’ll need thousands of people to send them comments telling them why that would be so harmful for trans people. In the meantime, NCTE and other organizations defending health care access will keep working to put pressure on the Trump administration.
Have you experienced discrimination from a health care provider or insurance plan? Have you benefitted from health care non-discrimination protections? Let us know, and we will use your story to help protect health care for all of us.
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