Biden administration restores protections for gay and transgender Americans seeking health care

(CNN) — The Biden administration announced a new rule Friday expanding safeguards against potential discrimination of gay and transgender Americans seeking medical care, in a reversal of Trump-era limitations that nixed federal health protections for members of the LGBTQ+ community.

In a set of expansive new rules unveiled by the Department of Health and Human Services, the department moved to advance civil rights protections for patients by barring health providers and insurers receiving federal funding from discriminating against those seeking care on the basis of gender identity or sexual orientation. The HHS rule restores Obama-era protections for transgender patients that the Trump administration rolled back in 2020 — a move that was condemned by LGBTQ+ advocacy and human rights organizations.

“Today’s rule is a giant step forward for this country toward a more equitable and inclusive health care system, and means that Americans across the country now have a clear way to act on their rights against discrimination when they go to the doctor, talk with their health plan or engage with health programs run by HHS,” HHS Secretary Xavier Becerra said in a Friday statement.

The finalized rule comes as access to gender-affirming care for transgender youth has been tangled in political controversy, with more than 20 states in recent years attempting to restrict youth access to such care. As conflicting rulings on state-level bans have emerged from lower-level courts across the country, the Supreme Court has faced mounting pressure to consider the matter.

The contested rule stems from Section 1557 of the Affordable Care Act, which bars “discrimination on the basis of race, color, national origin, sex, age or disability in specified health programs or activities.” The new HHS guidelines stipulate that while Section 1557’s prohibition on sex discrimination includes LGBTQ+ patients — and bans limiting access to care based on a patient’s sex assigned at birth or gender identity — exemptions based on health care providers’ religious beliefs still apply.

A 2016 interpretation of the clause under President Barack Obama expanded the ban on sex discrimination to encompass gender identity, but the HHS under Trump announced, on the four-year anniversary of the Pulse Nightclub shooting, that it was striking “certain provisions of the 2016 Rule that exceeded the scope of the authority delegated by Congress in Section 1557.”

“HHS will enforce Section 1557 by returning to the government’s interpretation of sex discrimination according to the plain meaning of the word ‘sex’ as male or female and as determined by biology,” the 2020 statement read. That move swiftly met with legal opposition from LGBTQ+ advocacy groups and was blocked by a federal judge a day before it was set to take effect.

The Biden administration in 2021 announced its intention to protect transgender Americans from health care discrimination through Section 1557 and Title IX regulations, citing a 2020 Supreme Court ruling that affirmed federal civil rights law bars discrimination against gay, lesbian and transgender workers.

Friday’s expansion of civil rights protections was applauded by human rights and LGBTQ+ advocacy groups, with Human Rights Campaign President Kelley Robinson commending the HHS regulation as a “crucial step forward by the Biden-Harris administration in the fight for complete health equity for LGBTQ+ Americans.”

“Countless Americans can now find solace in knowing that they cannot be turned away from health care they need just because of who they are or who they love,” she said in a statement provided to CNN.

CNN’s Devan Cole contributed to this report.

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