Transgender Rights

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Posted by: | Posted on: July 1, 2020

Healthcare Protections for the MA Transgender Community: Questions and Answers About State Protections and Attacks from the Trump Administration

You deserve and should expect to be treated fairly when accessing health care. If you do experience discrimination, contact GLAD Answers or Massachusetts Transgender Political Coalition and let us know. 

What has the Trump administration done to threaten healthcare protections for transgender people? 

On June 12, the federal Department of Health and Human Services released a final rule formalizing the Trump administration’s position that the nondiscrimination provision in the Affordable Care Act (known as Section 1557) does not protect transgender people from discrimination in health care, reversing HHS’s prior interpretation of the law. 

This move is the latest in a long line of dangerous attacks from the Trump administration targeting transgender people for political gain. It has the potential to cause confusion for providers, insurers, and employers, and to embolden those who wish to discriminate. 

While this is cause for concern, there are two pieces of good news: 

1) Massachusetts provides robust protections for transgender people in healthcare and

2) Following the June 15 Supreme Court ruling affirming federal LGBTQ workplace protections, there is good reason to believe the Trump administration’s interpretation of Section 1557 will ultimately not survive legal challenges. 

Are transgender people in Massachusetts still protected from discrimination in healthcare? 

Yes. 

Massachusetts has strong and comprehensive state-based laws that prohibit discrimination against transgender people in access to health care, including by insurers and health care providers. Those protections are not subject to the whims of the Trump administration. 

What are the Protections for Access to Health care for Transgender People Under Massachusetts Law? 

Insurance Coverage Directives Require Coverage for Gender-Affirming Care 

The Massachusetts Division of Insurance – which oversees private health insurance plans – the Group Insurance Commission – the agency overseeing health care plans for state employees – and MassHealth – the state’s Medicaid agency – have each issued directives requiring the coverage of all medically necessary gender-affirming care, including hormone therapy and surgeries. 

These directives are based on state law, are independent of federal law, and should not change. In fact, following the Trump administration’s June 12 announcement about its new interpretation of Section 1557, MassHealth issued a statement affirming the HHS rule would not have any negative impact on MassHealth coverage and treatment for transgender patients. 

State Law Protects Transgender People from Discrimination in Access to Health Care 

Massachusetts also has a state law prohibiting discrimination in access to “places of public accommodation” on the basis of a person’s gender identity. This law prohibits discrimination by health insurance companies in plan benefits as well as discrimination by a health care provider or entity, including hospitals and clinics. 

This law also exists independent of the federal ACA (or other federal nondiscrimination laws) and will not change. 

What does the Trump administration’s reversal of transgender healthcare nondiscrimination protections under the Affordable Care Act mean? 

The Trump administration has reversed an Obama-era rule that clarified that the prohibition against sex discrimination in the Affordable Care Act (ACA) bars discrimination against transgender people. That prior interpretation is in line with two decades of federal court rulings and the Bostock case recently decided by the United States Supreme Court. The new Department of Human Services (HHS) rule formalizes the Trump administration’s position that for the purpose of federal enforcement, discrimination against transgender people is not a form of sex discrimination and not prohibited under the ACA. 

The federal Department of Health and Human Services (HHS) is charged with enforcing the nondiscrimination protections in Section 1557 of the ACA by taking action against entities (such as hospitals and insurance companies) that receive federal funds and that violate the ACA. HHS’s new interpretation that Section 1557 of the ACA excludes protections for transgender people, means our federal government won’t take action against entities that deny healthcare access or coverage to transgender people. 

That is dangerous because it diminishes protections at the federal level and sends the message that it is okay to discriminate. 

If HHS won’t protect transgender people from discrimination, are there other ways people can seek relief for healthcare discrimination under federal law? 

Yes. People can also seek relief directly through the federal courts. The ultimate meaning of the non-discrimination protections under the ACA is up to the courts, not the Trump administration. And several federal courts have already agreed that transgender people are covered under the ACA’s prohibition against sex discrimination. 

Importantly, on June 15, 2020, in a landmark ruling about federal LGBTQ workplace protections, the U.S. Supreme Court affirmed that transgender status discrimination is a form of sex discrimination. While that ruling does not automatically settle the question in the healthcare context, it makes it much harder for the Trump administration – or anyone else – to argue that prohibitions against sex discrimination don’t protect transgender people. 

GLAD has a case in federal court right now challenging the denial of healthcare to a transgender man under the ACA’s non-discrimination provision. This case, Pangborn v. Ascend, will test the legitimacy of the Trump administration’s cruel, unjust and we believe unlawful position. 

What can we do? 

First, know your rights in healthcare and remember that you are protected under Massachusetts law. No matter how HHS interprets existing federal law, Massachusetts law prohibits discrimination in healthcare and prohibits private health insurers and our state Medicaid agency from having any exclusion of transition-related health care. Put another way, they are required to cover medically necessary gender affirming health services. That does not mean that some insurers won’t try to deny that some services are medically necessary for a particular individual. Those denials must be fought on a case-by-case basis. 

If you have questions or experience issues accessing healthcare coverage, there are MA-based organizations that can help. Contact GLAD Answers or Massachusetts Transgender Political Coalition

Second, share your story. With the attacks on healthcare coming from the federal administration, it is more important than ever to ensure we have and keep the strongest possible protections under state law. The MA Trans Health Coalition is working to ensure an even stronger commitment from Massachusetts insurers and the Department of Insurance to protect healthcare access for transgender people. You can help this effort by sharing your story of healthcare discrimination, or what access to fair healthcare coverage means to you. 

To share your story, contact Tre’Andre Valentine, Executive Director of the Massachusetts Transgender Political Coalition, at treandrevalentine@masstpc.org

Posted by: | Posted on: May 9, 2020

Guiding Principles for Gender Affirming Care During COVID-19

Guiding Principles for Gender-Affirming Care During COVID-19: Tips for Patients, Providers, and Insurers

 

Guiding Principles for Gender-Affirming Care During COVID-19: Tips for Patients

 

Guiding Principles for Gender-Affirming Care During COVID-19: Tips for Providers

 

Guiding Principles for Gender-Affirming Care During COVID-19: Tips for Insurers

Posted by: | Posted on: January 4, 2013

MTPC at First Event Conference & Action Day

MTPC at First Event Conference!
Volunteers Needed!
Marriott Peabody, in Peabody, Massachusetts

What better way to start off the New Year than being with friends and people from the Trans community while at the same time building support of our organization by telling them about us. MTPC is looking for great people to staff an information table at First Event, Saturday, January 26th between 9am to 4pm. If you have an hour or two to spare we would be so happy if you spent it with us. We will be collecting legislator postcards for the An Act Relative to Equal Access in Hospitals, Public Transportation, Nursing Homes, Supermarkets, Retail Establishments, and all other places open to the public. 

Please email your contact information and time available to Alishia at volunteer@masstpc.org

Massachusetts StatehouseAnd don’t forget about MTPC and the Transgender Equal Rights Coalition will be holding a Community Action Day at the Massachusetts State House on Thursday, January 17th at 11am in the Suite 167 conference room. All transgender people and our allies are encouraged to attend and meet with their legislators to ask for co-sponsorship for the Trans Equal Access Bill!


Please RSVP (http://www.masstpc.org/drupal6/civicrm/event/info?reset=1&id=8) so we can look up your legislators prior to the event.


Thanks!
MTPC
Posted by: | Posted on: January 19, 2012

Photos from the Signing of Trans Rights Bill With Governor Deval Patrick