Proposed rule to roll back progress in health equity for patients who identify as LGBTQ+

Written by: Samantha Espinoza
Date Posted: May 31, 2019

People who are LGBTQ+ face discrimination, denial of their human rights and social stigma within health systems according to Healthy People 2020, and this type of discrimination is linked to health disparities among adults and youth. In Colorado, the Healthy Kids Colorado Survey finds that high school students who identify as LGBTQ+ are three times more likely to report seriously considering suicide than their peers who identify as heterosexual. Nationally, people who identify as LGBTQ+ are more likely to commit suicide and less likely to seek health care services when they need them.  

In 2015, the Obama administration sought to mitigate LGBTQ+ health inequities caused by discrimination. The U.S. Department of Health and Human Services (HHS) extended protections against discrimination “based on sex” within the health care system to include people who are transgenderThis change prevented providers and insurers from refusing health care services based on gender identity. Unfortunately, the Trump administration is seeking to roll back these protections as well as protections for women, patients with limited English proficiency and anyone in need of reproductive health care. These proposals must undergo a 60-day comment period and we will be reaching out soon with instructions on how to make you voice heard. 

Last Fridayunder the Trump Administration, HHS released a new proposed rule which, if enacted, would remove current protections that bar health care workers and insurance companies from discriminating against patients based on their gender identity. Under the proposed change, doctors could refuse to see transgender patients or provide transition-related care. It does so by erasing all references to discrimination based on gender identity and sex stereotypes within the Affordable Care Act (ACA) and eliminating the Obama administration’s definition of sex that includes one’s internal sense of being “male, female, neither, or a combination of male and female.” 

The rollback doesn’t stop there. The proposed change would also affect anyone who experiences discrimination in a health setting, as it includes broad provisions that would limit the entities required to comply with discrimination rules and under what laws an individual can sue. Other provisions of the rule threaten access to services for women, patients with limited English proficiency, and anyone in need of reproductive health care, potentially eroding years of progress toward health equity.  

However, the proposed rule must undergo a 60-day public comment period before it is finalized. Just as the Colorado Children’s Campaign supported the expansion of health care protections in 2015, we will advocate now to uphold them. We know that patients who identify as LGBTQ+ face more barriers to care than their peers and believe the current protections are necessary to ensure health care is available to everyoneFollow KidsFlash to stay up to date on this proposal. We will announce when it is time to submit comments to protect the rights of individuals to receive the health care they need, without discrimination.

Samantha Espinoza

About Samantha Espinoza

Sam joined the Colorado Children’s Campaign staff as a Policy Analyst after serving as their Government Affairs Intern while completing her MSW at the University of Denver. Her portfolio of policy issues includes child health, family planning and maternal and infant mental health. Sam is a military veteran whose greater part of professional experience is grounded in research, advocacy and supporting children who face adversity.