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If you experience certain life changes, you don’t have to wait for Open Enrollment in November to enroll in affordable health coverage on healthcare.gov or your state’s marketplace. You have 60 days after the following events to apply for a Special Enrollment Period and enroll:

• Moving to a new zip code or county
• Getting married or divorced
• Having a baby, adopting or becoming a foster parent
• Becoming a U.S. citizen or getting a green card

You have 60 days before or after the following to enroll: 

• Losing your health insurance from your job
• Turning 26 and aging off your parent’s health plan

And if you are experiencing domestic violence and want to apply for your own health plan, you can do so at any time.

Learn more about Special Enrollment Periods at healthcare.gov or call 1-800-318-2596.

 

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Thursday
May302019

Trump's new rule would allow even more discrimination

Trump's new rule would allow even more discrimination

Late last week, the Trump administration issued a proposed rule undermining the nondiscrimination provision of the Affordable Care Act (ACA). Section 1557, also known as the Health Care Rights Law, prohibits any health program or activity that receives federal funding from discriminating against individuals on the basis of race, color, national origin, sex, age, or disability. The Trump proposal seeks to eliminate protections against discrimination for LGBTQ people and for individuals who have had or are seeking abortions, while simultaneously doubling down on religious exemptions that allow health care providers to deny care on the basis of their personal beliefs.

This proposed rule would likely subject members of the LGBTQ community to renewed, and possibly intensified discrimination in health care, such as in denial of gender transition services, purposeful misgendering, improper hospital room assignments and improper or hostile treatment by health care providers. It could also mean that patients could be denied medically-indicated terminations of pregnancy, such as in cases of reproductive emergencies.

In May 2016, the Obama administration issued final regulations implementing Section 1557 that interpreted “sex” in such a way as to bar discrimination against people based on pregnancy, gender identity, sex and gender stereotypes, or abortion. However, in December of that year, Texas federal court judge Reed O’Connor issued a nationwide injunction blocking key portions of the rule, including discrimination on the basis of gender identity or termination of pregnancy. (If O’Connor’s name sounds familiar, that’s because he’s the judge behind the “bananas” ruling in late 2018 striking down the entire ACA. That case is still pending.

Following release of the rule and before O’Connor’s injunction, victims of gender identity discrimination were briefly able to file complaints with the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR). Analysis of those complaints by the Center for American Progress (CAP) reveals just how critical those protections are. CAP found that “transgender patients who filed complaints were often denied [health care] in general, unrelated to transition-related treatments, solely because of their gender identity. … [H]ealth care providers most often discriminate against transgender people simply for being who they are.”

The Trump administration’s refusal to defend the rule or appeal O’Connor’s ruling, combined with separate court cases upholding protections for gender identity directly under the statutory language of 1557 itself, have left protections for trans health care in legal limbo ever since. Trans people may still be able to sue in the courts but unable to use the administrative remedies available through OCR.

On Friday, the Trump administration framed their current 1557 rewrite as necessary for complying with O’Connor’s ruling. In fact, HHS is simultaneously ignoring those contradictory decisions from other courts while going far beyond O’Connor in attempting to unwind longstanding protections written across a host of federal laws. For example, the Trump rule would erase such protections from all HHS health care regulations including those governing ACA marketplaces, Qualified Health Plans, Medicaid, and the Program of All-Inclusive Care for the Elderly. Even the ability of patients with limited English proficiency to receive information in their native languages is under attack in the proposal, spun as a way for insurers to cut costs.

Although the proposed rule may never go into effect and does not change the underlying law regardless, that may not be necessary to harm trans people and people seeking abortion care. Many patients will be afraid to seek health care in the first place or to speak up if they are turned away. Many biased providers will feel emboldened to discriminate free from consequence.

Furthermore, the rule is the latest in a series of extremist policies being pushed through the U.S. Department of Health and Human Services by Vice President Mike Pence and what Politico labeled his “Indiana mafia.” Women’s and LGBTQ health advocates have long feared a Pence presidency but the truth is that it’s already here.

As the Washington Post reported, “the proposal is part of a broader effort by religious conservatives in the Trump administration” to attack protections for transgender people beyond health care and across the entire federal government. “The Department of Housing and Urban Development on Wednesday proposed a rule that would allow federally funded shelters to turn away transgender people for religious reasons or force them to use bathrooms and sleeping areas that do not conform to their gender identity. A March 12 memo from the Defense Department outlined a policy that bans enlistment by anyone with a gender dysphoria diagnosis who is taking hormones or has transitioned to another gender. In addition, troops already in the military would have to serve according to the sex stated on their birth certificates.”

What can you do?

Before the proposed rule can be finalized, the administration must accept comments from the public and explain why each unique criticism, grouped by theme, is addressed in the final rule. The more comments they receive, the longer the delay before they can finalize the rule.

It is a critical time for you to voice your opinions about the repercussions of these proposed changes. (However, individuals should be aware that comments submitted to HHS are public, which may impact the kinds of stories or details individuals are comfortable sharing.)

Once the comment period is open, we will be writing with ways that you can speak up and be counted.

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