A new proposal from the Department of Health and Human Services would, if adopted, amend the Affordable Care Act (a.k.a Obamacare) by adding a provision against medical discrimination on the basis of gender identity. The ACA already prohibits discrimination based on of race, color, national origin, sex, age, or disability.
The proposed regulation delineates the types of practices that would be forbidden for insurers and health-care facilities that accept federal funding (e.g. Medicare and Medicaid). For instance, charging women more than men for health insurance or categorically excluding procedures related to gender transition.
The proposal has, been in the works for two years.
"The Department of Health and Human Service's proposed rules have the potential to be life-saving for transgender people," said National Center for Transgender Equality Executive Director Mara Keisling in response to the proposal.
"The medical and scientific consensus for years has been that transition-related care is medically necessary and should be covered by insurance. Many systems have voluntarily covered these services because it is the right thing to do from a medical perspective, from a fairness perspective, and because it can save them money."
The proposal doesn't outright require insurers to cover transition treatment, but rather says that people must be treated in a manner consistent with their gender identity. Insurers could face questions if they deny services that are medically necessary.
It also states that transgender people have equal rights in health care settings, including accessing facilities that match their gender identity, including hospital rooms and restrooms.
In addition, the rule assures that trans people can have access to sex-specific care and tests (e.g. breast or prostate exams), no matter what sex is listed on their health records.
The proposed rules are now in a public comment period that will last 60 days.