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LGBT People Would Get Anti-Bias Shield Under Health Insurer Rule (1)

Dec. 28, 2021, 9:15 PMUpdated: Dec. 28, 2021, 10:41 PM

Health insurers would be prohibited from discriminating against LGBTQ people under a proposed rule aimed at making it easier for consumers to find affordable health-care coverage in 2023.

The proposed rule (RIN 0938-AU65), released Tuesday, would add gender identity and sexual orientation back to a list of anti-discrimination protections under Section 1557 of the Affordable Care Act. A Trump administration rule in 2020 (RIN 0945-AA11) had removed those two identities from the list.

“Today’s rule is part of the Biden-Harris Administration’s ongoing efforts to ensure an equitable health care system as we continue to make coverage more accessible and affordable,” Health and Human Services Secretary Xavier Becerra said in a statement.

Prohibiting discrimination based on sexuality and gender identity “would increase access to health care, decrease health disparities,” the HHS said in a statement. It would also align with the Biden administration’s desire that people receive “equal treatment under the law,” regardless of their identity.

The HHS said in May that it would begin enforcing protections for LGBTQ Americans in health care in a reversal of the Trump-era rule.

“This will impact millions of LGBTQ Americans who, as the rule recognizes, face barriers with regards to access to insurance, health disparities, and cost,” Omar Gonzalez-Pagan, health-care strategist for civil rights group Lambda Legal, said Tuesday. “This is an important and good step in protecting the health and well being of LGBTQ people.”

A spokesperson for America’s Health Insurance Plans, a health insurer trade group, didn’t immediately respond to a request for comment.

Improving Access

The Notice of Benefits and Payment Parameters 2023 proposed rule would also require insurers in the federal health insurance marketplace and state-based marketplaces on the federal platform to offer standardized plan options, which would help consumers compare plans and select the most appropriate choice for their needs.

The CMS would conduct network adequacy reviews to ensure that consumers get easy access to the right type of provider in an accessible location. These reviews would “highlight key characteristics like time and distance to care, as well as appointment wait times,” the HHS said in a statement.

The proposed rule would support low-income people by requiring insurers to include 35% of essential community providers in their network. Such providers support communities that are traditionally underserved in health care. The current threshold is 20%.

The federal marketplace user fee rate would remain at 2.75% for the 2023 benefit year, and the state-based marketplace user fee rate would stand at 2.25%.

(Updated with comment from Lambda Legal in the sixth paragraph.)

To contact the reporter on this story: Allie Reed in Washington at

To contact the editors responsible for this story: Brent Bierman at; Alexis Kramer at