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What You What You Need to Know about Proposed Ruling which may Deny Care to Transgender Patients

HHS Ruling Web

May 1, 2019

This week, a coalition of national LGBTQ organizations – Out & Equal Workplace Advocates, Out Leadership, The Human Rights Campaign, and The National Center for Transgender Equality – published an analysis regarding the Department of Health and Human Services (HHS) intention to revise regulations to its non-discrimination policy. Such revisions may present significant challenges to the transgender community. Click here to view this detailed overview. 

Brief Overview

As reported by the Washington Post and others last week, HHS plans to publish proposed changes in section 1557 of Affordable Care Act, which threatens to undermine access to life-saving care for transgender people. Since 2012, this section – which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities – has been consistently interpreted to include discrimination on the basis of sex stereotyping and gender identity.

The proposed changes may expressly state that sex discrimination does not include gender identity or sex stereotyping/sexual orientation discrimination.  It may also contain new religious and/or conscience exemptions.

What it Means for Your Employees:

  • Even before changes are made, news like this can weigh heavily on your LGBTQ employees. Employees and/ or their family members may feel particularly at risk of harassment and discrimination. 
  • The prospect of these rollbacks may present imminent worry and stress. Employees may be reasonably distracted by thoughts such as, “What does this mean for my child’s healthcare? What if I need to go to the emergency room?”
  • LGBTQ employees already face significant barriers to healthcare. As reported in the analysis, one-third of transgender individuals reported a negative healthcare experience, and pervasive discrimination prevents many transgender and gender nonconforming patients from seeking care.

What You Can Do:

  • If you are personally impacted by the prospect of these rollbacks, contact us at Out & Equal for support. You should also be able to find support in HR, Benefits, your Employee Resource Group or other internal offices devoted to employee well-being.
  • If you are an ally, now is a good time to proactively lend support. A visible gesture of solidarity such as the trans equality flag or other emblem can go a long way.
  • If you manage staff – whether or not you think some are trans-identified – proactively communicating your own and your company’s values of trans inclusion can be critical in moments like this.

What it Means for Your Company:

  • The voice of business remains vital in standing up for access to healthcare for transgender people. Your impact cannot be overstated. With two-thirds of the Fortune 500 companies already providing trans-inclusive healthcare coverage, major businesses like yours know that ensuring that trans employees can be healthy and thrive is both the right thing to do and part of ensuring a vibrant workforce. (This is also true for other population groups).
  • There will be opportunities to provide corporate comments under any changes to1557. Out & Equal will be here in coalition with others to help you hone your message. If you are an ally, now is a good time to proactively lend support. A visible gesture of solidarity such as the trans equality flag or other emblem can go a long way.
  • As news rolls out, ensure your transgender employees feel supported in your firm’s internal and external communications, recognizing the weight this can place on their mental and physical well-being. Proactive communication is the best communication for cultivating support and belonging.




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Out & Equal is the global convener, thought leader and catalyst actively working to achieve workplaces of equality and belonging - supporting LGBTQ+ employees and leaders who thrive in their careers and lives and achieve greater impact on the world.