Statement on HHS Rulemaking Supporting Discrimination in Health Care - LGBTQIA+ Communities

 , June 26, 2020

On behalf of the Society of General Internal Medicine (SGIM), we want to express our outrage about the decision announced by the federal Department of Health and Human Services (HHS) on June 12 to finalize its revisions to the Affordable Care Act’s (ACA) Section 1557 regulation, making substantial changes that eliminate important protections across healthcare access and insurance. The rule removes requirements for healthcare providers to provide access to services for LGBTQ populations and severely limits requirements for insurance plans to provide non-discriminatory benefit plan designs.

The adoption of this rule will disproportionately negatively impact vulnerable populations during a once-in-a-Century pandemic, when the American public is witnessing access and outcome disparities across familiar racial and socioeconomic status lines. The rule is unconscionable and cruel. The ACA’s non-discrimination protections represented a critical step toward equitable access to care, treatment, and insurance. These protections have particularly benefited people affected by or at risk for Covid-19 and other infectious and chronic conditions as well as LGBTQ communities. A core priority for public health and SGIM is eliminating health disparities by reforming the systems that have exacerbated them; this rule does precisely the opposite.

The rule rolls back several non-discrimination protections, including: significantly narrowing the covered entities subject to the rule; removing prohibitions on discrimination based on gender identify and sexual orientation; creating stronger religious exemptions; and removing language access requirements.

Ironically, the US Supreme Court on Monday, June 15, voted 6-3, in a decision written by Justice Neil Gorsuch, that an employer who fires an employee on the basis of that employee’s sexual orientation or transgender status is in violation of Title VII of the Civil Rights Act of 1964.

We will not end the current pandemic without an unwavering commitment to health equity and to laws and policies that include non-discrimination protections. The HHS decision will only exacerbate stigma and hamper our efforts to provide excellent health care to every American.

The Society of General Internal Medicine is a member-based international medical association of 3,300 of the world's leading academic general internists, who are dedicated to improving access to care for vulnerable populations, eliminating health care disparities and enhancing medical education. SGIM strives to be the professional home for innovators and scholars in academic general internal medicine leading the way to better health for everyone. The members of the Society advance the practice of medicine through their commitment to providing comprehensive, coordinated, and cost-effective care to adults, educating the next generation of outstanding physicians, and conducting cutting-edge research to improve quality of care and clinical outcomes of all patients. www.sgim.org

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