News Release

KFF Examines New Rule Giving LGBTQ+ People More Protections Against Discrimination in Health Care

A long-awaited new rule recently finalized by the Biden Administration gives LGBTQ+ people more protections against discrimination when seeking health care and coverage from a range of programs and organizations, including Medicaid, Medicare, Health Insurance Marketplaces, many health insurance plans, and most hospitals and providers. The rule has been subject to a wave of litigation across the Obama, Trump, and Biden Administrations and the Biden Administration’s new rule reinstates protections eliminated by the Trump Administration.

In a new brief, KFF examines the rule and highlights two areas of interest— nondiscrimination protections for pregnancy related decisions, including abortion, and nondiscrimination protections for transgender people, including those related to gender affirming care. The brief also provides a side-by-side comparison of the Obama (2016), Trump (2020), and Biden Administration (2024) rules.

The revised regulations implement Section 1557 of the Affordable Care Act, which prohibits discrimination based on race, color, national origin, age, disability, or sex in covered health programs or activities. The Biden Administration’s interpretation of the ACA’s sex protections also offers protections based on sexual orientation and gender identity, among other considerations.

Beyond those for LGBTQ+ people, the rule also provides a range of other nondiscrimination protections, including those related to abortion; people with disabilities; people with limited English proficiency; and use of telehealth and patient care decision support tools, including clinical algorithms and AI. The rule also extends to include Medicare Part B for the first time.

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The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.