For the first time, Funders for LGBTQ Issues is issuing public comments and we are doing so in opposition to proposed changes to Section 1557 of the Patient Protection and Affordable Care Act. The changes threaten the health and wellbeing of LGBTQ communities, immigrants, and anyone seeking reproductive healthcare.

Up until now, Section 1557 clarified that discrimination against LGBTQ people in healthcare settings and health insurance benefits is unlawful. Now, the Trump Administration is proposing to remove such guidance.

The proposed rules change would harm our most vulnerable community members by:

• Sowing confusion among healthcare workers and insurance companies by giving the impression that discrimination against LGBTQ people, particularly transgender people, is permissible.
• Granting medical providers a broad religious exemption whereby they could use their personal beliefs rather than their professional obligations to decide whom they will serve, potentially resulting in a wide range of people being turned away from life-saving care: LGBT people, unmarried people, or people who have had an abortion or need one.
• Eliminating the requirement that health programs post notices about the availability of language access programs, making it harder for people with limited English proficiency or disabilities to access medical care, and removing the mandate that discrimination based on immigration status is prohibited.

Please note that submitting public comments regarding a proposed regulation is not considered lobbying, which is narrowly defined as the attempt to influence specific legislation. Submitting comments on proposed rules – such as these proposed changes to Section 1557 – is a permissible advocacy activity for both public and private foundations to engage in. For more information, please see these guidelines on advocacy and lobbying for foundations from the Council on Foundations.

If you have questions about Section 1557 or submitting comments please contact Lyle Matthew Kan, Vice President of Research & Communications, at [email protected].

Information on Submitting Public Comments:

Submission Deadline: No later than 11:59pm EST on August 13, 2019.

How to Submit: Submit comments directly via www.regulations.gov. You can submit your comment of any length as a PDF. If you are interested in submitting by mail, click here for details.

Share Your Comment with Funders for LGBTQ Issues: Please email a copy of your submitted comment to Funders for LGBTQ Issues’ Research & Communications Associate Luis Rey Ramirez at [email protected]. Funders for LGBTQ Issues is aiming to track which member foundations submit comments and share the comments on our website.

Tips for Comments:

• Make at least 30% of your comment different from the template to ensure “uniqueness.” For comments to be officially “counted” by HHS, they have to be different from one another in terms of the language that is used.
• Clearly state your opposition to the rules change.
• Include any studies or reports as attachments along with your comment. This ensures that it is part of the public record. A good practice is to upload a single PDF that includes any cited reports, studies, or data.
• Submit your comment via www.regulations.gov to ensure timely receipt. If you decide to submit your comment by mail, submit early and send by certified mail.

Section 1557 Public Comments Template:

Additional Resources for Section 1557 Public Comments & Talking Points:

• Kaiser Family Foundation (KFF) analysis, HHS’s Proposed Changes to Non-Discrimination Regulations Under ACA Section 1557
• Guide to Commenting on Health Care Rights Law (Section 1557) Proposed Rule (from the National Center for Trans Equality and other community organizations, intended for non-grantmaking nonprofits, but includes sample language, legal arguments, and other sources to learn more about the transgender communities in your region)
• National Health Law Program (NHeLP) Questions and Answers on the proposed rollback of nondiscrimination protections under the ACA’s Section 1557
• Protect Trans Health Campaign
• National Women’s Law Center: “The Trump Administration Proposes a Sweeping Rule to Allow Widespread Discrimination in Health Care.”
• Nina Esperanza Serrianne & Wilmarie Rios Jamie of the National Latina Institute for Reproductive Health,“The Trump Administration Is About to Make It Harder for People With Limited English Proficiency to Get Health Care,” Rewire.News.
• Williams Institute, “HHS Aims to Roll Back Non-Discrimination Potections for More Than 1.5 Million Transgender People.”

Image note: Photo by Hush Naidoo on Unsplash