The proposed rule would implement Section 1557 of the Affordable Care Act. Section 1557, the key nondiscrimination provision of the Affordable Care Act, was the first U.S. law to ban sex discrimination in federally funded health care. Section 1557 prohibits discrimination based on sex, among other characteristics, in health programs and activities. Section 1557 does not prohibit discrimination based on sexual orientation or gender identity. The proposed rule would interpret the term “sex” in Section 1557 to include gender identity and sex stereotypes.
The rule would extend protections from discrimination in healthcare to LGBT people nationwide. The rule would be particularly important for LGBT people who live in states without state-level non-discrimination laws.
The comment summarizes existing research on health disparities and discrimination facing LGBT people, demonstrating the need for nationwide protections from discrimination in healthcare. The comment also draws on existing case law and legal arguments to demonstrate that discrimination based on sexual orientation and gender identity are forms of sex discrimination, and as such, should be prohibited by Section 1557.