The Biden administration has announced new protections for gay and transgender medical patients, prohibiting federally funded health providers and insurers from discriminating on the basis of sexual orientation and gender identity. This new rule reverses a policy that was instituted by the Trump administration and fulfills President Biden’s pledge to restore civil rights protections for L.G.B.T.Q. individuals that were revoked by his predecessor. Health and Human services secretary Xavier Becerra described the rule as a significant step forward towards creating a more equitable and inclusive health care system in the U.S.
The rule overhauls federal policy in an area that has become a political flashpoint, with more than 20 Republican-led states having banned or restricted gender-affirming care for minors in recent years. This change is likely to draw legal challenges and has taken on three different forms under three successive presidents. The Affordable Care Act, passed in 2010, established a set of civil rights protections in the U.S. health system through Section 1557, which prohibits discrimination against patients based on various factors including race, color, national origin, sex, age, or disability in any health program or activity receiving federal funds.
The Obama administration issued a less expansive version of the rule finalized by the Biden administration on Friday in 2016, requiring health providers to provide medically appropriate treatment for transgender patients. This rule was tied up in litigation and the Trump administration chose not to enforce it. Conservative opponents of the rule argue that doctors could be coerced into performing medical services they oppose, possibly on religious grounds. The Trump administration formally narrowed the legal definition of sex discrimination in 2020 to exclude protections for transgender individuals.
The new rule by the Biden administration preserves religious exemptions and does not mandate the provision of any particular medical service. It emphasizes that Section 1557 prohibits discrimination on certain prohibited bases and does not interfere with individualized clinical judgment regarding patient care. After the Supreme Court ruled that the Civil Rights Act of 1964 applies to discrimination based on sexual orientation and gender identity, the Biden administration began to reverse the policy implemented by the Trump administration. Republican officials have worked to keep the Trump-era rule in place, with some threatening legal action against the Health and Human Services Department if the policy was pursued.
Advocates and opponents scrutinized the proposed rule, with the Health and Human Services Department receiving over 85,000 comments on the matter. Groups that advocated for the reversal of the Trump-era rule praised the Biden administration’s decision. The president of the Human Rights Campaign, Kelley Robinson, stated that countless Americans can now take comfort in knowing they cannot be denied health care based on who they are or who they love. This new rule is seen as a victory for LGBTQ rights and a crucial step in creating a more inclusive and equitable health care system in the U.S.
