The American Heart Association (AHA) is a nonprofit and nonpartisan organization that represents more than 100 million patients with cardiovascular disease (CVD) and includes more than 33 million volunteers and supporters committed to our goal of improving the cardiovascular health of all human beings. As the nation’s oldest and largest voluntary organization dedicated to building healthier lives free from cardiovascular disease and stroke, the AHA has long advocated for health equity, access to quality health insurance coverage, and evidence-based medical services and treatment for all individuals.

• AHA Comments on Proposed Rule on Nondiscrimination in Health and Health Education Programs or Activities

  The AHA opposed the repeal of transgender-specific protections under Section 1557 of the Affordable Care Act noting: "Transgender people also face a high degree of insurance discrimination. Historically, many plans have used transgender-specific exclusions to deny transgender people coverage for medically necessary care—including hormone therapy, mental health counseling, and surgeries—even though the same services are routinely covered for non-transgender individuals. While the 2016 rule resulted in the elimination of transgender-specific exclusions from many private health insurance policies, transgender people continue to face a high number of denials for transition-related care. ...

  This discrimination is not limited to transition-related care and, rather, affects all health care access for transgender people. ... These experiences of health care and health insurance discrimination contribute to significant health disparities. The LGBTQI community faces higher rates of substance use, including tobacco; higher rates of mental health issues; a higher risk of HIV and other sexually transmitted diseases; and a higher risk of certain types of cancer (due in part to reduced access to cancer screening). Relative to heterosexual people, lesbian, gay, and bisexual individuals are more likely to rate their overall and cardiovascular health as poor, have more chronic health conditions, have higher prevalence and earlier onset of disabilities, and have a heightened risk for CVD."

  Date: 2019