Advocacy Briefs

Biden Administration Reinstates ACA Protections for Transgender and All LGBTQ People

On Monday, May 10th, the Biden administration reinstated Obama-era protections included in the Patient Protection and Affordable Care Act (ACA) for transgender and all LGBTQ people. This move undoes the Trump administration’s reversal of these protections. Under this restoration, healthcare providers who receive federal funding may not discriminate against individuals on the basis of gender identity.

The ACA mandates protections for all individuals seeking healthcare. Specifically, Section 1557 of the ACA explains that individuals may not be discriminated against, denied benefits of, or denied participation in any health program or activity that is federally funded or established under Title I of the Act. This includes protection against discrimination on the basis of race, color, national origin, sex, age, disability, and sexual orientation, in addition to gender identity.

President Biden’s announcement comes amid a recent series of attempts by multiple state legislatures to pass bills that would curb transgender people’s rights and access to healthcare services. It remains to be seen how such current or future discriminatory legislation at the state level will be dismantled following the reinstatement of ACA protections. As the Biden Administration continues to roll out new bills, such as the American Jobs Plan, many of these laws will likely embed additional components from the ACA. The purpose of doing so is to bulwark protections and policies from the ACA against any threats intended to repeal the Act. Ensuring that healthcare is affordable and accessible is a commitment that President Biden made on the campaign trail and will remain a pressing interest as the nation grapples with and emerges from the pandemic.

This move represents important groundwork for achieving health equity. Providers must continue to build upon this groundwork, however, through education and training on LGBTQ health, cultural competency, and systemic barriers to care. Legislation alone will not resolve issues of access: regardless of the law, the social determinants of health that exceed its scope will still impact transgender people’s and other underserved populations’ ability to access the care they need. Health service providers can help address this by staying ahead of the political curve in their organizational culture and policies.

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Section 1557 of the Patient Protection and Affordable Care Act

By: Charlotte Kugler & Henry Butenschoen

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