A new brief analyzes the Trump Administration’s proposed changes to federal anti-discrimination regulations that would eliminate existing protections in health care related to gender identity and access to abortion, and narrow protections for non-English speakers.

The proposed rule issued June 14 by the Department of Health and Human Services would substantially revise regulations implementing the Affordable Care Act’s Section 1557, which prohibits discrimination based on race, color, national origin, sex, age and disability in health programs receiving federal funding. 

If implemented, the proposed changes would scale back the rights and protections available to patients and consumers while reducing the anti-discrimination requirements on health insurers and providers. Specific changes include:

• Eliminating the general prohibition on discrimination based on gender identity, as well as specific protections for transgender individuals. This could allow providers to refuse to treat or cover services for people who are transgender or otherwise do not conform to traditional gender identities.
• Providing blanket exemptions for health care providers and organizations related to providing or paying for abortion or to requirements that they consider inconsistent with their religious tenets. This could mean people seeking abortion, contraception, or other services could have their treatment denied, delayed or discouraged based on a provider’s religious beliefs.
• Eliminating the provisions preventing health insurers from varying benefits in discriminatory ways. This could allow insurers to require higher cost-sharing for all or most drugs used for a specific condition such as HIV or to market their plans in ways designed to encourage or discourage certain groups from enrolling.