In response to letters from LGBTQ health and advocacy groups, the Department of Health and Human Services (HHS) announced in a letter made public yesterday that, under the Affordable Care Act, discrimination based on gender identity will not be tolerated. Leon Rodriguez, director of HHS' Office for Civil Rights, stated in a written response to the groups that federally-funded health care programs are barred from discriminating against transgender people. This inclusion does not, however, mean that trans-specific health care, such as transition-related procedures, will be included in coverage.So! After I saw this last night, I emailed Eastsidekate about it and we talked about it some, and I was all "LOL YER ENFORCEMENT?" and Kate was all, "THX FOR NOTHING!" and then we covered ourselves in ice cream and ate it off each other's heads.
The National Center for Transgender Equality's executive director Mara Keisling notes that one in five transgender people report being turned away from a health care provider. "HHS affirms our position that these abuses are now clearly illegal," said Keisling. She remarked that this position will hopefully be a tool to get to the next step of covering trans-specific health care.
Trans and health care advocates assert that it is important for trans people to know their rights [pdf] regarding health care, and to contact HHS when they experience discrimination. The HHS Office of Civil Rights will soon release guidelines for how to respond to health care discrimination. Trans activist Jos Truitt writes, "a law specifically targeting [trans] discrimination would be a valuable next step, and showing that the need exists could help make this a reality."
Because today's HER BIRTHDAY!
Okay, in all seriousness, this is, as Kate aptly described it an one of her emails, "good-ish, but meaningless." Which means, by way of an inexact parallel, that it's sort of like the Lilly Ledbetter Fair Pay Act—or, more specifically, the framing around the Lilly Ledbetter Fair Pay Act, which tends to overstate what it actually accomplished. Which was increasing the statute of limitations in which women who discover they are being paid unequally can sue, but not really ending unequal pay.
Similarly, this provision is good news in the sense that it provides recourse for trans* people who experience discrimination, but note the distinction between "guidelines for how to respond to health care discrimination" (which are forthcoming) and guidelines for preventing health care discrimination (which evidently are not).
What would be more meaningful is if the HHS barred discrimination and delineated good-faith practices for health practitioners, instead of barring discrimination and telling trans* people to report back if and when they're still denied healthcare.
As it stands, the policy is simply incomplete.
On Twitter last night, Kate drily noted: "My wife and I got a letter from NYS after I spent a night in my car while she was in the ER. Anti-discrimination rules aren't all bad. If that happened again because I'm trans, I'd be entitled to *two* letters."
I guess what it boils down to is this: As a start, it's a good one. As a best effort at a comprehensive policy, it's shit.
We'll have to wait and see what the HHS thinks it is.