Biden takes steps to restore health protections for LGBTQ Americans


The Biden administration decided Monday afternoon to restore protections for LGBTQ Americans and other groups seeking health services that were canceled during the Trump era, saying the rule would also cover pregnant women. seeking health services, including abortion.

The rule proposed by the Department of Health and Human Services aims to clarify that discrimination based on sex includes decisions regarding “termination of pregnancy”. It comes as the federal health department has previously pointed to federal civil rights laws — including parts of Obamacare — to warn pharmacists to deny access to drugs that can be used for abortions.

Health care organizations that receive federal funding would also be barred from discriminating against gender transitions and other services that are increasingly the target of legislative battles and state litigation. Officials also pointed out that new federal anti-discrimination language covers a patient’s sexual orientation and gender identity.

“I think most Americans know their right to be free from discrimination — but too often, some communities don’t have that freedom to exercise their right to access care,” the authorities told Monday. reporters HHS Secretary Xavier Becerra. “We want to make sure that whoever you are, whatever you look like, wherever you live, however you want to live your life, you have access to the care you need.”

The proposed rule strengthens a provision, Section 1557 of the Affordable Care Act, that was crafted under the Obama administration but weakened by its successor and has been the subject of much litigation. The proposal also became as part of the Biden administration’s strategy to ensure access to abortion following the Supreme Court’s decision to overturn Roe vs. Wade.

“We are very pleased to be able to make this announcement today. This comes at an important time, especially after the Supreme Court’s erroneous decision in DobbsBecerra said, referring to the High Court ruling that led to abortion restrictions coming into effect last month.

Experts said they were still analyzing the implications of the proposed rule in the battle over abortion rights, as a cascade of states implemented new restrictions.

“I think people who oppose this rule will try to interpret it as a mandate for abortion. It’s so far from it,” said Katie Keith, director of health policy and of legal initiative at the O’Neill Institute of Georgetown Law.

HHS also asked the public on Monday to submit comments on the impact of the Dobbs decision on health care, which officials could use to make changes to the final version.

The Biden administration “can just hold its cards because it’s afraid of the backlash,” said Roger Severino, who led HHS’s civil rights office during the Trump administration and predicted the final rule could be ” more aggressive” on access to abortion. .

LGBTQ advocacy organizations applauded the announcement, saying the Biden administration was right to restore and expand federal language that would protect those seeking gender transition, people with disabilities and other victims of discrimination.

“Today’s proposal restores essential protections that have been undermined by the Trump administration,” Kellan Baker, executive director and director of learning at the Whitman-Walker Institute, said in a statement.

The White House had been considering the proposed rule since March, arranging meetings with advocates from the Heritage Foundation, the Family Research Council and other conservative and religious organizations that opposed reversing the Trump-era changes. The groups argued that the rule change would force health care providers to perform procedures against their religious beliefs or allow children to begin gender transitions that they may later regret.

“All we’re trying to do is advocate caution and compassion based on evidence, not ideology,” said officials from Genspect, an international parent group that has questioned the need for genre transitions, wrote to administration officials in April after a meeting.

HHS officials said Monday they have sought to incorporate some of the groups’ concerns, pointing to provisions that explicitly address protections for providers who raise conscientious or religious objections to performing certain procedures such as abortion.

“It’s kind of a victory,” said Severino, who oversaw a Trump-era effort to establish an office focused on conscience and religious freedom for health care providers. But he said other parts of the proposal were “downright scary,” citing provisions he said could be used to punish doctors who refuse to perform transition-related surgeries because of state or local laws, or because they don’t believe the procedures are clinically appropriate.

“If you think they’re ever clinically appropriate, you’re considered a fanatic by the government,” resulting in a loss of federal funds, said Severino.

LGBTQ groups, meanwhile, have spent months warning that patients’ rights are under attack at home, at work and in court.

“Gender-affirming healthcare is essential healthcare,” David Brown, legal director of the Transgender Legal Defense & Education Fund, said in a statement last month, after a federal court ruled that a plan North Carolina State Health Authority was wrong to deny patients access to hormone replacement therapy, surgeries and other care related to gender transitions.

The proposed rule would apply to health insurance plans that do business through the Obamacare, Medicaid or Medicare grants. For the first time, the non-discrimination provisions would apply to Medicare Part B, which covers doctor’s visits, some preventive services and other outpatient care for people age 65 or older or receiving health benefits. disability. HHS officials said they are concerned that the Obama-era iteration of the rule may have inadvertently resulted in gaps in federal protections.

Biden administration officials say they are bracing for legal challenges, amid ongoing litigation that has contributed to delays in its release. The Biden administration previously said in legal documents that the proposed rule would be released in April.

“There’s no doubt that someone can challenge us and say we’re not interpreting the law correctly,” said Becerra, who previously served as California’s attorney general and sued the Trump administration over its own changes to the law. rule. “We think we are.”

The Trump administration had also reduced requirements that most health care providers publish information in 15 languages ​​and make translation services available. The new rule aims to restore access to language assistance services.

“It’s a small, maybe, but it’s also very important,” Becerra said.

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