Biden administration to reverse Trump’s ‘unlawful’ LGBTQ+ healthcare rollback

President Joe Biden is seen wearing a white button up shirt, blue tie and dark suit jacket as he stands in front of a yellow background

The Biden administration has laid out plans to reverse a Trump-era attack on LGBTQ+ healthcare.

The Affordable Healthcare Act’s (ACA) non-discrimination protections prohibit “discrimination on the basis of race, colour, national origin, sex, age and disability in certain programs and activities”.

Under Obama, “sex” covered sexual orientation and gender identity. The Trump administration revised this definition, so that LGBTQ+ people were not covered by the rule.

Now, the White House plans to correct Trump’s wrongs by bringing back the original protections. HHS said restoring and strengthening the rule is part of Biden’s promise to advance “gender and health equity and civil rights”. 

The proposal would clarify that sex covers “sexual orientation and gender identity”. It would also make it clear that discrimination based on sex includes pregnancy or “related conditions, including ‘pregnancy termination’.” 

HHS secretary Xavier Becerra said that “standing with communities in need is critical” – “particularly given increased attacks on women, trans youth and healthcare providers”. 

“Healthcare should be a right not dependent on looks, location, love, language or the type of care someone needs,” Becerra said. 

Xavier Becerra is standing at a podium as he speaks into a microphone. Becerra is wearing a white shirt and dark suit and tie. There is an American flag seen in the background

Xavier Becerra says it’s important the Biden administration stands with communities in need, including LGBTQ+ people. (Getty/Alex Wong)

Melanie Fontes Rainer, acting HHS office for civil rights, added it was more important than ever for the Biden administration to “stand up for those around the country whose voices often go unheard” and that officials are “working to ensure they can access healthcare free from discrimination”. 

“Today’s proposed rule is a giant step in working to ensure that goal is met,” Rainer said. 

LGBTQ+ advocacy organisations welcomed the announcement and said it was only right for the Biden administration to restore protections for queer people accessing healthcare free from discrimination. 

Omar Gonzalez-Pagan, counsel and healthcare strategist for Lambda Legal, said the announcement marked a “pivotal moment in restoring regulatory nondiscrimination protections for those who need them most” while ensuring the “further reach possible” of the ACA’s healthcare nondiscrimination law. 

“The Trump administration wrongly and unlawfully sought to eliminate these much-needed protections for LGBTQ+ people and people with limited English proficiency, among others, by carving them out from the rule and limiting the scope of entities to whom the rule applied,” Gonzalez-Pagan said. 

He also said the rule will help LGBTQ+ people – “especially transgender people, non-English speakers, immigrants, people of colour and people living with disabilities” – to access the care they “deserve, saving lives and making sure health care professionals serve patients with essential care no matter who they are”.

Julianna S. Gonen, federal policy director at the National Center for Lesbian Rights, said the ACA’s “core promise of healthcare for all” that was “free from discrimination” was “stymied” by those who would “deny care to LGBTQ people simply because of who they are”. 

“We are thrilled to see that the Biden administration intends to implement section 1557, the ACA’s nondiscrimination provision, consistent with federal sex and religious liberty discrimination law and without creating sweeping new exemptions that would endanger healthcare for all,” Gonen said. “We support the proposed rule enthusiastically and look forward to its final adoption.”