AMA urges HHS Office of Civil Rights to retain sex-nondiscrimination policies
Following reports that the Trump administration may be revising its sex non-discrimination policies, the AMA has urged the HHS Office of Civil Rights (OCR) to retain its current policy of interpreting sex discrimination to include discrimination based on gender identity and sex stereotypes. In a letter (PDF) to OCR Director Roger Severino, the AMA wrote that it opposes any discrimination based on an individual's sex, sexual orientation, gender identity, race, religion, disability, ethnic origin, national origin or age. AMA policy also supports public and private health insurance coverage for treatment of gender dysphoria as recommended by the patient's physician.
Section 1557 makes it unlawful for any health care provider who receives funding from the federal government to refuse to treat an individual—or to otherwise discriminate against the individual—based on race, color, national origin, sex, age or disability. The OCR has long interpreted Section 1557's sex-discrimination prohibition to extend to claims of discrimination based on gender identity or sex stereotypes and accepted such complaints for investigation. These protections assist some of the populations that have been most vulnerable to discrimination, such as lesbian, gay, bisexual and transgender individuals and those suffering from mental illness, including substance-use disorders, and help provide those populations equal access to health care and health coverage.
Of note, Section 1557 does not force physicians to violate their medical judgment. Rather, covered entities—including insurers—must apply the same neutral, nondiscriminatory criteria used for other conditions when the coverage determination is related to gender transition. The AMA urged OCR to seek input from stakeholders about whether informal guidance may help to clarify misunderstandings of the existing rule.
