In June 2020, the Department of Health and Human Services released its final rule rolling back protections from discrimination based on sex stereotypes, sexual orientation, and gender identity under the Affordable Care Act. LGBT people, state governments, and health care providers have filed lawsuits in federal courts across the country arguing that HHS violated several federal laws, including the Administrative Procedure Act, in issuing the rule.
The rule attempts to strip federal protections from sexual orientation and gender identity discrimination in health care for the 13 million LGBT people age 13 and older in the U.S. Federal law provides the only source of protection from discrimination in health care for nearly 7 million LGBT people who live in states without statutory protections against sexual orientation and gender identity discrimination in public accommodations. The rule also limits access to health care for people with limited English proficiency, a disability, or other issues that create a barrier to care.
The final rule stands to exacerbate discrimination and negative health outcomes for LGBT people, who face high levels of rejection and discrimination in health care. The experience and expectation of rejection and discrimination are “minority stressors,” which adversely impact LGBT people’s health and well-being. As a result, LGBT people encounter health disparities compared to non-LGBT people.