The Trump administration unveiled on Friday its second attack in three days on the rights of transgender people and women, proposing a rule that would gut Obama-era protections against discrimination in the medical field.
The proposed rollback of the Healthcare Rights Law, or Section 1557 under the Affordable Care Act (ACA), would remove discrimination protections for transgender people and patients who have obtained abortions, suggesting that it's acceptable for healthcare providers to refuse care to such patients.
"Trans people are being killed in the street and the administration wants to help facilitate more death," Chase Strangio, a staff attorney at the ACLU, tweeted. "Announcing policies that will take away healthcare and shelter protections in a single week...So many people will die."
Read the rule here. This would carve #LGBTQ people out of the #ACA's nondiscrimination protections, & invite health care workers, doctors, hospitals, insurance companies that receive fed funding to refuse to provide/cover services critical to health. https://t.co/KwDuduGpMH
— Lambda Legal (@LambdaLegal) May 24, 2019
Here we go, folks...the official announcement of plans to change Section 1557 of the ACA, which prohibits discrimination “on the basis of sex” to include termination of pregnancy and gender identity.
The war on trans folx and reproductive rights... https://t.co/7FH8pATg4u
— Debi Jackson (@the_debijackson) May 24, 2019
The Healthcare Rights Law prohibits discrimination in the medical field on the basis of sex, race, religion, and other characteristics, and in 2016 the Obama administration included "gender identity" and a history of "termination of pregnancy" as examples of sex discrimination.
"I shudder to think what this rule will inspire."
—Fatima Goss Graves, National Women's Law CenterUnder the new proposed rule, the medical field would no longer be directed to take gender identity—defined by the Obama administration as one's "internal sense of gender, which may be male, female, neither, or a combination of male and female, and which may be different from an individual's sex assigned at birth"—into consideration and would instead recognize gender as tied only to physical characteristics at birth.
The proposal gives tacit approval to doctors if they refuse to treat transgender patients or otherwise treat them unfairly, and could lead to transgender Americans facing even more barriers to quality care than they already do, critics say.
"Predicated on little more than prejudice, this proposal will abandon two million Americans who already face significant barriers to accessing adequate and life-saving health care," Mara Keisling, executive director of the National Center for Transgender Equality, said in a statement. "If permitted, this rule will promote ignorance and hate that no American should have to face while seeking care, and we are ready to fight it with everything we've got."
This is despicable. Trans people already experience greater barriers to accessing health care than cis people.
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— UltraViolet (@UltraViolet) May 24, 2019
Numerous studies have identified a lack of medical training for doctors regarding how to care for transgender patients, difficulty obtaining insurance coverage, and outright discrimination as impediments to quality care that transgender people face.
Kris Hayashi, executive director of the Transgender Law Center, warned that the rule will directly put some of the most vulnerable populations in the U.S. in danger.
"Everyone should be able to go to the doctor when we need help without being turned away or denied treatment because of who we are," Hayashi said in a statement. "This rule dangerously encourages illegal discrimination, putting the lives of transgender people in jeopardy—particularly for trans people living with HIV, Black transgender people and people of color, trans people with disabilities, and rural and Southern trans folks."
Under the rule, the Health and Human Services Department (HHS) would also lift discrimination protections for women who have had abortions, allowing doctors to refuse them care. The rule was introduced weeks after the administration proposed another measure which would allow doctors and nurses to decline to treat people if the provider has moral or religious objections.
"The Trump-Pence Administration is attacking abortion rights AGAIN through a proposed rule to gut protections under the Health Care Rights Law," Rep. Barbara Lee (D-Calif.) tweeted. "This proposed rule is dangerous and wrong."
National Women's Law Center president Fatima Goss Graves expressed concern that the rollback of Section 1557 would have wide-ranging effects on patients who already face marginalization.
"The Healthcare Rights Law was groundbreaking," Goss Graves said in a press call. "It meant that finally there were explicit discrimination protections in healthcare...It meant no provider could refuse to treat a woman because she had an abortion."
"I shudder to think what this rule will inspire," she added. "I worry today about the patients in this country that are scared that they won't get the care they need."