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Nationwide transgender individuals face significant barriers to accessing health care because of their gender identity; however, little is known about the experiences of the estimated 55,000 transgender individuals in Georgia as they interact with the health care system. Understanding the health care needs, access barriers, and discrimination experiences of transgender individuals in Georgia can inform the work of advocates, stakeholders, and policymakers to reach the shared goal of ensuring health equity for all Georgians, especially transgender Georgians.
To inform the public about these barriers to care, Georgians for a Healthy Future, Georgia Equality, and The Health Initiative are releasing a policy brief, Voices for Equity: How the experiences of transgender Georgians can inform the implementation of nondiscrimination provisions in the Affordable Care Act.
Voices for Equity: How the experiences of transgender Georgians can inform the implementation of the ACA’s nondiscrimination provisions
The passage of the Patient Protection and Affordable Care Act (ACA) was notable not only for increasing access to health insurance coverage for millions of Americans but also for its broad non-discrimination provisions. Section 1557 of the ACA prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in many health programs and activities. The final rule determined that discrimination on the basis of gender identity and sex stereotyping are equally prohibited under Section 1557, and as a result, lesbian, gay, bisexual, transgender, and queer (LGBTQ) Georgians have protections from discrimination in health coverage and care for the first time. To better understand the challenges that transgender Georgians may face when accessing health care, GHF, GE, and THI collected data and information from transgender Georgians that provided compelling narrative of barriers that transgender individuals routinely face when seeking health care and utilizing their health insurance.
The goals of this policy brief are:
- describe the protections for transgender individuals under Section 1557 of the Affordable Care Act.
- discuss the results from a series of transgender focus groups and survey of the LGBTQ community in Georgia, and the 2015 U.S. Transgender Survey to understand transgender individuals’ experiences in health care.
- recommend actions that health care providers, policy makers, and advocates can take to support improved health care access and equity for transgender Georgians.
Resources for LGBT consumers
Thanks to Section 1557 of the Affordable Care Act, LGBT Georgians have protections from discrimination in health coverage and care for the first time. If you believe you have been discriminated against, it is important to file a 1557 complaint with the Office of Civil Rights in the Department of Health and Human Services. GHF and our partners can help you with that! Visit GHF’s LGBT Health Equity page for more information and help to file your complaint.
On May 13, the U.S. Department of Health and Human Services (HHS) issued a final rule implementing Section 1557 of the Affordable Care Act, an important milestone in the movement towards health equity. Section 1557 prohibits discrimination based on race, color, national origin, sex, age, or disability in all health programs and activities that receive federal financial assistance through HHS, are administered through HHS, or are established under Title 1 of the Affordable Care Act. As a result, most health insurance plans, facilities, programs, and providers are covered under this rule.
Notably, Brooksville chiropractic marks the first time that sex discrimination in health care is prohibited and also clarifies that gender identity and sex stereotyping are included in this definition. Because of these provisions, LGBT Georgians have protections from discrimination in health coverage and care. For specific information on the gender identity and sex stereotyping provisions of Section 1557, see Out2Enroll’s FAQ here. For Georgia-specific information about health insurance options for LGBT Georgians, check out the series of fact sheets that Georgians for a Healthy Future teamed up with Georgia Equality and The Health Initiative to release this past fall.
Discrimination against individuals with limited English Proficiency (LEP) is also prohibited in the health care programs and activities covered by the rule (defined under national origin). More than 1.3 million Georgians have LEP. In addition, the final rule requires effective communications with individuals with disabilities.
If you believe you have been discriminated against, you can file a complaint online with the Office for Civil Rights. If you are an enrollment assister looking for resources to educate the consumers you help about their protections under Section 1557, you can access FAQs and fact sheets from HHS here.