Have you heard? The Affordable Care Act prohibits discrimination against LGBT people in health insurance and in accessing health care in EVERY state. On May 13, 2016, the Office for Civil Rights at the U.S. Department of Health and Human Services released a final rule with new protections for LGBTQ people across the country. The rule bans discrimination based on gender identity and sex stereotyping in most types of health insurance coverage and by most types of health care providers. Here are a few key things to know:
- All LGBTQ people are protected from discrimination in health insurance coverage and health care. The rule contains explicit protections for transgender, gender nonconforming, non-binary, and intersex individuals as well as LGB people based on sex stereotyping.
- The rule bans categorical transgender exclusions in most types of health insurance. The rule does not mandate or otherwise require coverage of transition-related care – so there is no specific list of services that must be covered. However, if a plan covers a certain treatment for a non-transgender person person, it cannot be denied to a transgender person based on their gender identity. Trans exclusions in private health plans do not have to be removed until January 1, 2017 but all other types of coverage – including Medicaid – must remove trans exclusions by July 18, 2016.
- The rule protects LGBTQ people from discrimination when accessing health care. Most health providers – including hospitals, nursing facilities, community health centers, state Medicaid agencies, and state public health agencies (among others) – are prohibited from discriminating against LGBTQ people. This means that health care providers can’t discriminate against you because of who you are in a relationship with. It also means that a hospital, for example, must place a transgender or gender nonconforming individual in a room or ward according to their gender identity, rather than their sex assigned at birth or recorded gender. The final rule also prohibits harassment, such as a provider intentionally refusing to use a transgender person’s correct name and pronoun.
- If you experience any form of discrimination, have a trans exclusion in your plan, or if your coverage is denied you should file a complaint with the Office for Civil Rights and let us know at firstname.lastname@example.org. It doesn’t matter what type of plan or provider. It can be frustrating to file a complaint, but this is especially important given the lack of clarity about what must be covered. The more complaints, the more likely we are to get more guidance in the future.
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