Dive Brief:
- The proposed rules would prevent insurers from denying coverage for treatments to help people transition to another gender, according to information from the Department of Health and Human Services.
- This would apply to insurers and healthcare providers that receive HHS funding - including insurers that participate in government-run marketplaces or sell Medicare Advantage plans and those insurers' private employer plans. The rules also require providers to better communicate with non-English speaking people and those who are disabled. Also, services cannot be restricted based on gender identity.
- The proposal is open for public comment until November 6. The new rules expand on a section of the Patient Protection and Affordable Care Act (PPACA) that prohibits discrimination in healthcare programs.
Dive Insight:
HHS said "explicit categorical exclusions in coverage for all healthcare services related to gender transition are facially discriminatory." Samuel Bagenstos, a law professor at the University of Michigan told The New York Times: "This rule actually contains the most significant affirmation of the rights of transgender individuals of equal treatment in healthcare and health insurance that has existed anywhere in the law."
Jocelyn Samuels, director of HHS' Office for Civil Rights told reporters: "This rule does not require that any particular services be provided. It does require that insurers apply non-discriminatory criteria to assessing the services that they will cover."