6.12 Trump administration rolls back LGBTQ health care protections

Denver, CO — Just hours ago, the Trump administration repealed a rule in section 1557 of the Affordable Care Act, which provided protections against LGBTQ discrimination in health care and health insurance.

One Colorado, the state’s leading advocacy organization for lesbian, gay, bisexual, transgender, and queer (LGBTQ) Coloradans, released the following statements:

During Pride Month and on the fourth anniversary of the Pulse massacre, the Trump administration has issued another rollback of protections for LGBTQ Americans. In the height of a global pandemic — when LGBTQ people are already at-risk — this rule will allow health care providers to deny LGBTQ Americans the health care they need. Despite these federal rollbacks, protections in Colorado remain for plans regulated by the Division of Insurance – which prohibits discrimination based on someone’s sexual orientation or gender identity. One Colorado will continue to advocate for comprehensive protections so that no one can be denied the care they need.” 

– Daniel Ramos, Executive Director,  One Colorado 

“The decision by the Trump administration today to rollback nondiscrimination protections for LGBTQ Americans is appalling. We know from our 2018 Closing the Gap report, that 36 percent of LGBTQ Coloradans are not open with their provider about their sexual orientation or gender identity because they fear discrimination. This rule will drastically exacerbate occurrences of discrimInation and the fear of discrimination that keeps LGBTQ Coloradans from accessing care. This decision is especially harmful considering that LGBTQ people have been disproportionately impacted by both the health and the financial crises we are currently facing.”

– Marvyn Allen, Health Equity & Training Director, One Colorado

The new rule removes the following protections from the Affordable Care Act (ACA):

  • Any recognition that the ACA prohibits discrimination against LGBTQ people.
  • Any recognition that the ACA prohibits discrimination based on sex stereotypes.
  • Any recognition that the law prohibits benefit designs that discriminate, for example, against people living with HIV.
  • Ten unrelated HHS rules that prohibit anti-LGBTQ discrimination in specific programs.

In the fall of 2019, One Colorado sent a detailed letter to Health and Human Services Secretary, Alex Azar, outlining concerns about the rule change. On May 6th, 2020, One Colorado staff had a meeting with the White House Office of Management and Budget to discuss the negative impacts the rule change will have for LGBTQ Coloradans.

In One Colorado’s 2019 report, “Closing the Gap: The Turning Point for LGBTQ Health,” explored the impact of the ACA for LGBTQ Coloradans. The ACA has extended health insurance coverage to more than 600,000 Coloradans through the public health exchange and Medicaid expansion, eliminated pre-existing conditions and transgender-specific exclusions, established cost parity, clarified that spousal benefits must apply to same-sex couples, and removed limits on annual and lifetime spending for people with chronic conditions. As of 2018, only five percent of the LGBTQ community in Colorado were uninsured, compared to ten percent in 2011.

While Coloradans will still be protected from discrimination, this new rule will further create confusion between the application of state and federal law. The state of Colorado passed the Colorado Anti-Discrimination Act (CADA) in 2008, which protects people from discrimination based on their sexual orientation and transgender status in place of employment, education, and public accommodation, including within medical settings. At the beginning of June, the Colorado Department of Regulatory Agencies launched a LGBTQ-specific Health Care Rights and Resources page to help explain the rights and protections of LGBTQ Coloradans when accessing health care and benefits. If people experience health care discrimination in Colorado, they should contact the Colorado Civil Rights Division to file a complaint. Complains must be filed within 60 days of the incident.