This post originally appeared on The 19th.
LGBTQ+ Americans now have greater protections against discrimination when seeking health care, whether from hospitals, doctors, Medicaid programs, and health insurance plans, according to a new rule released Friday by the Biden administration.
LGBTQ+ advocates have been waiting for these finalized protections for several years, since the administration said in 2021 that it would interpret Supreme Court precedent to broaden nondiscrimination protections under the Affordable Care Act (ACA).
The new regulation undoes rulemaking under the Trump administration that excluded transgender people from nondiscrimination protections in the ACA and expands Obama-era protections for LGBTQ+ people. The language is broader than the Biden administration’s initial policy proposal, as it refers less often, and less explicitly, to sexual orientation and gender identity while still laying a foundation to protect against LGBTQ+ discrimination. Potential exemptions for religious groups are also more easily obtainable under the new rules, although not as extensive as they could have been.
Julianna Gonen, federal policy director with the National Center for Lesbian Rights, wants LGBTQ+ Americans to know that they do not have to accept mistreatment in doctor’s offices — a phenomenon that many queer and trans people face on a daily basis. The law is on their side, she said, even if they live in a red state with hostile policies.
Gonen has seen how some LGBTQ+ people feel resigned to discrimination in health care settings. At a 2018 rural community meeting in North Dakota, a same-sex couple — one of whom was transgender — told the group that they had been turned away by a doctor’s office and told “we don’t treat people like you here.”
“I was shocked to hear that, and I pointed out that that treatment is unlawful. But these folks didn’t know that. They thought that because they lived in a red state, that’s just what they had to live with,” she said. The implementation of these regulations will be so important because of those experiences, Gonen said; these laws need to be on the books, and LGBTQ+ people need to be aware of their protections.
“The protection exists in the Affordable Care Act, but it’s really helpful and important that regulations make very clear who’s covered. Because the Affordable Care Act says you can’t discriminate in health care based on sex. And we know, because of how federal law has evolved, that does include sexual orientation and gender identity,” she said. Gonen joined other LGBTQ+ policy experts in discussions with the Department of Health and Human Services (HHS) during the final rulemaking process for the new regulations.