The government moved Thursday to strengthen protections against discrimination for women, transgender people, the disabled and others who receive their health care insurance under the Affordable Care Act or participate in any health program provided by the Health and Human Services Department.

The ACA, known as “Obamacare,” already bars discrimination based on sex and other factors, but the proposed regulation issued Thursday spells out the kinds of practices not allowed by health care providers and insurers.

Women, for example, could not be charged more than men for insurance or services because they need pre-natal or maternity care. Insurers could no longer categorically exclude coverage for gender transition services, though they would not automatically have to provide surgery or other care and would have to explain the reasons for denial.

People who speak limited English may be eligible for interpreters and translators so they could understand their diagnoses and treatments. The disabled might be able to demand access to sign language interpreters or technology that better helps them communicate with health care providers.

“This proposed rule is an important step to strengthen protections for people who have often been subject to discrimination in our health care system,” Health and Human Services Secretary Sylvia Mathews Burwell said in a prepared statement. She said the administration is committed to “giving every American access to the health care they deserve.”

A doctor, for example, couldn’t ask a woman’s husband to be the guarantor of her payments if he didn’t ask the wife to be the guarantor for the husband. A dependent daughter couldn’t be denied maternity coverage if she is on her mother’s insurance.

Transgender people have long complained of widespread discrimination in the provision of health care, “from disrespect and harassment to violence and outright denial of service,” according to a 2011 report, “Injustice at Every Turn.”

In the survey, 19 percent reported being refused care, 28 percent were subjected to harassment and 2 percent said they were victims of violence in doctors’ offices.

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