HHS Comments Closed

The comment period for the proposed change in ACA Section 1557 has closed and it set a record in the number of comments received.

The Transgender Law Center reported,

Record-Breaking 132,400 People Have Spoken Out To #ProtectTransHealth From Trump
August 14, 2019
By Anna Castro

As of the August 13 deadline for public comments on the Trump administration’s proposed rollback of a regulation protecting transgender people’s access to health care, a national coalition of civil rights organizations collected over 132,400 comments in defense of transgender health — more than any other regulation since Regulation.Gov was launched in 2003.

The National Center for Transgender Equality and Transgender Law Center created the Protect Trans Health campaign in response to the May 24 announcement that the Department of Health and Human Services planned to roll back the Health Care Rights Law, an Obama-era regulation making it clear that discrimination against transgender people by providers, hospitals, and insurers is illegal. To learn more about the administration’s plan to deny transgender people equal treatment, visit ProtectTransHealth.org.

According to HHS, the department itself received over 130,000 comments before the coalition finished contributing all of its own. However, as of now, HHS has failed to make any of these comments available to the public.

Along with 125 Congress members…

This record-breaking achievement was made possible by the work of a national coalition of civil rights organizations that includes the National Center for Transgender Equality, Center for American Progress, TransChance Health, CenterLink: The Community of LGBT Centers, The National LGBTQ Task Force, the National Partnership for Women and Families, NARAL Pro-Choice America, the Center for Reproductive Rights, the National Women’s Law Center, the American Civil Liberties Union, Planned Parenthood Federation of America, the Human Rights Campaign, the Asian and Pacific Islander American Health Forum, Women’s Health and Reproductive Rights, FORGE, PFLAG National, the National Council of Jewish Women, In Our Own Voice: National Black Women’s Reproductive Justice Agenda, National Health Law Program, Transgender Legal Defense and Education Fund, Lambda Legal, Center for Constitutional Rights, The Leadership Conference Education Fund, Equality Federation, and Raising Women’s Voices for the Health Care We Need.

And just about every LGBTQ+ organization in Connecticut submitted comments including CTAC.

Dear Secretary Azar,

As the executive director of the Connecticut TransAdvocacy Coalition and on behalf of our Board of Directors, we appreciate the opportunity to submit these comments in opposition to the proposed rule changing the current definition what constitutes discrimination “on the basis of sex” under ACA Section 1557.

HHS’s proposed rule represents a retreat from existing federal regulations which protect health consumers, particularly but not exclusively LGBTQ+ consumers, from discrimination.  Among other things, the proposed rule re-opens the door to forms of discrimination on the basis of gender identity or gender stereotyping that are currently forbidden, including:

•     Permitting insurance plans to deny, cancel, refuse to issue or renew coverage, deny claims, impose additional cost sharing, or deny benefits, on the basis of gender identity or gender stereotyping;

•     Allowing health insurance companies and healthcare providers to stop treating individuals consistent with their gender identity; and

•     Allowing healthcare providers to invoke blanket abortion and religious objection exemptions from the regulation’s general prohibition on sex discrimination.

The proposed rule amounts to a retreat from HHS’s existing regulations to protect consumers from discrimination, which have helped to expand health coverage and access to health care for approximately 12,400 transgender adults in Connecticut, as well as many uncounted transgender children.  It expands the latitude that health insurance companies and healthcare providers have to discriminate against people on the basis of their gender identity, gender expression, or on the basis of the services that they require. This is not acceptable.

Transgender people experience discrimination that leads to health disparities.  Discrimination against transgender patients in health care settings leads to those patients postponing preventive or routine care and avoiding needed care when sick or injured.  Transgender people have an equal right to receive health insurance and healthcare without being discriminated against.

Transgender healthcare is medically necessary healthcare and is supported by the American Medical Association (AMA), American Psychological Association (APA), American Academy of Pediatrics (AAP), National Association of Social Workers (NASW), and the World Professional Association for Transgender Health (WPATH).

Many transgender people are working minimum wage jobs therefore many trans people have to work multiple jobs to make ends meet and those jobs are usually under 20 hours a week so the employer doesn’t have to give employee to give insurance benefits and as a result many transgender employees have to buy insurance through ACA.

The 2015 US Transgender Survey of over 28,000 transgender people found that only fourteen percent (14%) of respondents had individual insurance plans that they or someone else purchased directly from an insurance company, through healthcare.gov, or from a health insurance marketplace, 5% have Medicare, 13% were insured through Medicaid, TRICARE or other military health care 2%, and the VA 3%

The Williams Institute found that suicidal idealizations decreased when transgender people had proper healthcare and the health of transgender individuals increased with proper care.

We are also concerned about healthcare providers being able to invoke religious exemptions and refusing to give medical care to us. There have been a number of cases where medical providers refused to provide medical treatment to us that resulted in death. In one case a transgender woman slipped and fell on ice and the emergency room personnel refused to give her medical care. She later found out that she had fractured her hip and spine.

Allowing healthcare providers to refuse to treat us and especially in emergency situations can result in death or permanent disability.

Transgender equality in health care and health coverage is important to me and other transgender people. In addition, it is an important part of securing public health and achieving HHS’s own policy goals of reducing the number of uninsured people in America, and ensuring that consumers receive the health services they require in a timely and cost-effective manner. For all of these reasons, I urge HHS to reject the proposed rule and leave the current regulations in place.

Thank you,
Executive Director
Connecticut TransAdvocacy Coalition [CTAC]

Personally, even is all of the 130,000+ responses were against the change I don't think don't think it will make a difference. The Trump administration will just move forward with their bigotry and hatred... but it will make a difference in the courts.

Press conference at the Legislative Office Building (LOB) against Trump's changes.

Sen. Richard Blumenthal joined lawmakers and advocates on Tuesday at the behest of State Health Advocate Ted Doolittle to stand in opposition to a Trump administration proposal that would eliminate discrimination protection for transgender people. (CT Mirror/ Moore)