The U.S. Department of Health and Human Services this week released proposed regulations that will clarify and reaffirm that Section 1557, the nondiscrimination provision of the Affordable Care Act, protects LGBTQ+ people in access to healthcare services (i.e. receiving medical care in doctors’ offices, hospitals or other settings) and in health insurance. The proposal explicitly includes care related to gender transition and reproductive healthcare including abortion among medical care covered by the nondiscrimination provision.

The proposal would both reinstate and expand regulations issued under the Obama Administration clarifying that the prohibition against discrimination based on sex includes gender identity and sexual orientation. Former President Trump issued a subsequent interpretation of Section 1557 in June of 2020 attempting to deny protections for transgender and LGB people and adding broad religious exemptions. Following the Supreme Court Bostock ruling that same month affirming that prohibitions against sex discrimination include LGBTQ+ people, the Trump rule was blocked in federal court.

The Biden administration has pledged to issue regulations clarifying the implementation of Bostock across all federal agencies. This week’s HHS proposal accomplishes that in the critical domain of healthcare, where transgender and LGBQ+ people continue to face discrimination.

“While the Trump-era rule was always unlawful, it caused considerable confusion and concern among providers, insurers, and LGBTQ+ people,” said Jennifer Levi, GLAD Transgender Rights Project Director. “No one should ever be denied essential medical care because of bias. This proposed rule will provide clarity and will ensure people can access the healthcare they need.”

HHS will soon open a public comment period for the proposal. GLAD will work with LGBTQ+ partners to encourage comments in support of the updated rule.