The American Psychological Association condemned the administration's efforts to use federal rules to dismantle civil rights protections in health care for vulnerable populations, particularly transgender and gender non-conforming patients.
A proposed rule, issued today by the Department of Health and Human Services, would weaken existing regulations implementing the Affordable Care Act's non-discrimination in health care provisions.
The proposed changes to the Affordable Care Act are part of a sustained effort to gut this important law and to make health care less accessible to underserved populations. Weakening discrimination protections is damaging and unnecessary and will place vulnerable populations at risk of losing key aspects of their health care coverage."
APA CEO Arthur C. Evans Jr., PhD.
The proposed rule seeks to change a portion of the law known as Section 1557 of the Affordable Care Act, which prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs or activities. APA supported including non-discrimination protections in the Affordable Care Act when it was originally drafted and has advocated for strong enforcement of Section 1557 since the law was enacted in 2010. Psychological research has shown that discrimination in health care settings is closely tied to behavioral health disparities among vulnerable populations, and perceived discrimination is a key factor in chronic stress-related health disparities among women, racial and ethnic minorities and sexual and gender minorities.
The revised rule would also make it easier for providers to ignore the legitimate needs of non-English-speaking patients.
"The revised rule implementing Section 1557 of the ACA would severely limit or even eliminate patient access to comprehensive, clinically necessary health care," Evans added. "Instead of weakening protections for vulnerable populations who need increased access to quality care, we need to do everything we can to put patient welfare front and center in all health care settings."
This action comes on the heels of HHS' issuing a rule to expand health care providers' ability to refuse to provide services or perform research on the basis of religious, moral, ethical or "other reasons," which are not specified.
These so-called "conscience protections" are likely to prevent access to reproductive health care and information, particularly for low-income and minority women, and could also prevent access to care and information for other populations, specifically lesbian, gay, bisexual and transgender people and individuals living with HIV and AIDS.
"While APA fully supports the religious freedom of psychologists and other health care providers, that freedom is already enshrined in law and need not be expanded," Evans said. "The ethics code for psychologists is clear: Patient welfare comes first."