New Obamacare Regulation Presses for Sex Change Surgery Coverage

Now we’ve heard everything folks. Friday the Administration, the same day it ordered schools to allow students to use bathrooms or locker rooms matching their chosen gender identity, issued a directive that could pressure the nation’s insurers, as well as federal programs such as Medicare, Medicaid, or providers through Obamacare marketplaces to cover sex change procedures.

“The final rule does not require covered entities to cover any particular procedure or treatment for transition-related care, including gender reassignment surgery,” a spokesperson for the Department of Health and Human Services told The Washington Free Beacon. “However, it does bar a covered entity from categorically excluding from coverage or limiting coverage for all gender transition-related services.”


The new HHS directive enforces the Affordable Care Act’s section 1557, which forbids discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities.

In addition to ruling that “categorical coverage exclusions or limitations for all health care services related to gender transition are discriminatory,” including services such as breast implant surgery, hormone therapy and sex change surgery, the directive says:

Women must be treated equally with men in the health care they receive and the insurance they obtain;

Individuals must be treated consistent with their gender identity, including in access to facilities.

Individuals cannot be denied healthcare or health coverage based on their sex, including their gender identity and sex stereotyping.

Providers may not deny or limit treatment for any health services that are ordinarily or exclusively available to individuals of one gender based on the fact that a person seeking such services identifies as belonging to another gender.

Sex-specific health programs or activities are permissible only if the entity can demonstrate an exceedingly persuasive justification, that is, that the sex-specific health program or activity is substantially related to the achievement of an important health-related or scientific objective.


The rule is a win for civil rights issues, HHS said in its press release, as it is the “first federal civil rights law to broadly prohibit discrimination on the basis of sex in federally funded health programs.”

“A central goal of the Affordable Care Act is to help all Americans access quality, affordable health care,” HHS Secretary Sylvia Burwell said through the release. “Today’s announcement is a key step toward realizing equity within our healthcare system and reaffirms this administration’s commitment to giving every American access to the health care they deserve.”


Advocates for the LGBT communities also praised the new rules.

“LGBT people have too often faced healthcare systems that provide inequitable and hostile treatment. This new and important regulation will address many of these disparities and is critical to help end discrimination against transgender and gender nonconforming people in healthcare and insurance,” Human Rights Campaign President Chad Griffin said in a press release.


According to The Federalist, the new rule could open the way for lawsuits from transgender people on claims that being denied sex-change medical services is a violation of civil rights.

Meanwhile, many states already prohibit private insurers from excluding services for gender transition needs, reports The Free Beacon, including California, Oregon, Washington, Colorado, Illinois, New York, Vermont, Rhode Island, Connecticut, Massachusetts, and the District of Columbia.

Transgender people have faced barriers for years for health insurance and coverage of medical treatments, reports The Huffington Post, and in 2015, a Reuters survey showed more than 40 percent of people transitioning from women into men said they had faced discrimination while seeking healthcare.


One response

  1. What A Total Bunch Of BS!

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