Commissioner Lara joins insurance regulators across the nation supporting Biden Administration action restoring health care protections for transgender Americans

News: 2022 Press Release

LOS ANGELES — California Insurance Commissioner Ricardo Lara, together with 21 insurance commissioners from across the nation, submitted a joint letter to U.S. Secretary of Health and Human Services Xavier Becerra supporting the Biden Administration’s proposed regulatory action addressing unfair discriminatory treatment of transgender consumers. The letter affirms that, if adopted, the proposed rule “would promote civil rights protections for millions of consumers, ensure a level playing field for regulated entities, and enhance state insurance markets.”

The proposed changes seek to restore federal regulations implementing protections under Affordable Care Act (ACA) Section 1557, which prohibits sex discrimination in health insurance. The proposed regulations clarify that sex discrimination includes discrimination based upon a person’s gender identity or transgender status, protecting transgender Americans from being denied medically necessary care. In June 2020, the Trump Administration adopted regulations that reversed these protections, threatening access to medically necessary care for many transgender consumers already vulnerable to discrimination in health care, housing, and employment.

“Health care is a right for all. Everyone should be treated fairly with equal access to medically necessary health care, regardless of their gender or sexuality,” said Insurance Commissioner Ricardo Lara, who is California’s first statewide openly LGBTQ+ elected leader. “Many state insurance regulators join me in strongly welcoming the Biden Administration’s action to restore the true intent of the Affordable Care Act, which is expanding coverage, not limiting it.”

The insurance commissioners signing this letter include California, Colorado, Delaware, the District of Columbia, Hawaii, Illinois, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and Wisconsin. Despite the Trump Administration’s reversal of long-standing protections, many state insurance commissioners continue to enforce state and federal laws prohibiting health discrimination and have issued directives and regulations ordering insurance carriers to halt harmful and discriminatory practices targeting people based on gender or sex. In fact, immediately following the Trump Administration announcing rules that eliminated nondiscrimination protections in the federal Affordable Care Act, Commissioner Lara issued a Notice to California health insurance companies that they remain subject to the state’s nondiscrimination laws and must continue to provide equal access to medically necessary health care to all, regardless of their gender or sexuality.

“Transgender people should have equal access to the same health insurance and care as every other insured American. This includes health care related to gender affirmation, which for years has been recognized by every major U.S. medical society as effective and medically necessary for many individuals, as well as routine tests and treatment that are often denied to transgender individuals based on their gender identity (such as pap smears or prostate cancer screenings),” the letter states. “Consumer protection is a core part of our mission and responsibility as regulators, and it includes ensuring that no person, transgender or not, is treated unfairly or is subject to discrimination.”

Advocates for health equity welcomed the multi-state action. “Everyone in the United States should have fair, equitable access to healthcare,” said Olivia Hunt, Policy Director at the National Center for Transgender Equality. “We applaud the insurance commissioners for taking a clear stand in support of transgender and nonbinary people not just in their states, but across the country. Restricting or denying someone’s healthcare on account of their gender identity or transgender status is immoral, unethical, and profoundly un-American. We proudly join the commissioners in asking the Biden-Harris administration to implement these regulations as quickly as possible, and to be bold in enforcing them.”

“Many states and state insurance commissioners have taken strong action to ensure that the consumers they represent can access the health care services they need,” said Kellan Baker, Executive Director of the Whitman-Walker Institute. “All consumers deserve access to vital health care services, delivered by providers who treat them with dignity and respect. Particularly as efforts to restrict access to gender-affirming care intensify nationwide, it is essential for the federal government to adopt strong and unambiguous protections under Affordable Care Act Section 1557 that prohibit discrimination on the basis of gender identity, as well as sexual orientation, sex characteristics, and pregnancy status.”

The California Department of Insurance under Commissioner Lara’s leadership also submitted detailed public comments supporting the Biden Administration’s regulatory action.

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Media Notes:

• Joint letter of insurance commissioners
• California Department of Insurance public comments
• Final public comments on the regulatory action RIN 0945-AA17 were due on October 3.
• Following the Trump Administration announcing rules that eliminate nondiscrimination protections in the federal Affordable Care Act, Commissioner Lara issued a Notice to California health insurance companies about their requirement to comply with California laws.
• In 2019, Commissioner Lara led the effort with 17 other state insurance commissioners to submit a letter to the Secretary of the U.S. Department of Health and Human Services to protect rules addressing unfair treatment of transgender consumers. The Department of Insurance submitted detailed opposition to the Trump rules on ACA discrimination protections on August 13, 2019; the Trump Administration adopted the rules on June 12, 2020.