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The Biden Administration has recently finalized a long-awaited new rule that provides more protections against discrimination for LGBTQ+ individuals seeking health care and coverage. This rule applies to various programs and organizations, such as Medicaid, Medicare, Health Insurance Marketplaces, health insurance plans, hospitals, and providers. The rule reinstates protections that were previously eliminated by the Trump Administration and has faced litigation across multiple administrations.

KFF has examined the new rule in a brief, focusing on two key areas of interest: nondiscrimination protections for pregnancy-related decisions, including abortion, and protections for transgender individuals seeking gender-affirming care. The brief also includes a comparison of the rules from the Obama (2016), Trump (2020), and Biden (2024) Administrations.

The revised regulations are based on Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin, age, disability or sex in covered health programs or activities. The Biden Administration’s interpretation of the ACA’s sex protections also includes protections based on sexual orientation and gender identity among other factors.

In addition to protections for LGBTQ+ individuals, the rule also includes nondiscrimination provisions related to abortion rights for individuals with disabilities

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