Following on the heels of an order late Thursday that declared transgender students across the nation must be allowed to use school bathrooms in accordance with their gender identity, the Obama administration on Friday issued a “final rule” under Obamacare that bans discrimination against transgender patients.

Transgender people must be provided transition-related services and cannot be denied health care by providers or professionals who receive federal funding, according to a final rule announced Friday by the U.S. Department of Health and Human Services. The rule specifically bans the denial of coverage or health care itself on the basis of gender identity.

The rule, which comprises several regulations, was formed under Section 1557 of the Affordable Care Act, which includes first-of-its-kind civil rights protections in health care for several classes of people — including a ban on discrimination on the basis of sex.

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The new rule concludes that anti-transgender discrimination is sex-based discrimination. The rule also does not provide a ‘religious freedom’ exemption:

During a comment period last fall, some groups requested that “the rule should exempt faith-based providers from providing particular services, such as services related to gender transition, that are inconsistent with their religious beliefs,” the rule says.

However, it continues, federal officials “decided against including a blanket religious exemption,” instead noting that existing federal laws that protect religious freedom were already sufficient.

And while the new rule does not explicitly ban discrimination based on sexual orientation, such a ban could be not far off:

In a press release Friday, the Department of Health and Human Services said its civil rights office will “evaluate complaints that allege sex discrimination related to an individual’s sexual orientation to determine if they involve the sorts of stereotyping that can be addressed under 1557. HHS supports prohibiting sexual orientation discrimination as a matter of policy and will continue to monitor legal developments on this issue.”