• Health programs can't discriminate against LGBTQ patients
• Rule follows US Supreme Court decision in Bostock

The Biden administration is bolstering civil rights protections for transgender and other LGBTQ people in a federal rule that could quickly face legal challenges.

The final rule (RIN 0945-AA17), announced Friday by the Department of Health and Human Services, reverses a Trump-era regulation and restores gender identity and sexual orientation discrimination protections under Section 1557 of the Affordable Care Act.

Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability by entities that primarily provide health care and receive federal funding. It is enforced by the HHS Office for Civil Rights.

The new rule "means that Americans across the country now have a clear way to act on their rights against discrimination when they go to the doctor, talk with their health plan, or engage with health programs run by HHS," HHS Secretary Xavier Becerra said in a statement.

The new rule comes as over 20 states have limited or banned gender-affirming care for children, according to KFF. KFF also noted that over a dozen states are facing lawsuits over their youth gender affirming care policies.

The rule also follows the US Supreme Court's 2020 decision in Bostock v. Clayton County, in which the justices ruled that LGBTQ people are protected from discrimination under Title VII of the Civil Rights Act of 1964.

In light of Bostock, the Biden administration in 2021 announced it would interpret the word "sex" in the ACA to include gender identity.

Under the rule, the HHS will enforce its provisions for health insurance plans that do business through Medicare, Medicaid, or the Obamacare exchanges, including care provided under Medicare Part B, like that in a doctor's office.