The U.S. Department of Health and Human Services (HHS) has issued a proposed rule that implements Section 1557 of the Affordable Care Act (ACA). Section 1557 prohibits discrimination based on race, color, national origin, sex, age, and disability in certain health programs and activities. After a 2020 rule limited this section’s scope and power to cover fewer programs and services, the newly proposed rule reinstates and strengthens civil rights protections for individuals in certain federally funded health and HHS programs.
The proposed rule acknowledges and reiterates protections against discrimination based on sex, including sexual orientation and gender identity, consistent with the U.S. Supreme Court’s decision in Bostock v. Clayton County. HHS Secretary Xavier Becerra also pointed out that the proposed rule outlines protections from discrimination for those seeking reproductive health care services. The rule is a further manifestation of the Biden administration’s commitment to furthering gender and health equity and civil rights, as outlined in Biden’s various Executive Orders.
Among the many provisions in the proposed rule are the following:
- Reinstates the coverage of Section 1557 to include HHS health programs and activities;
- Requires health insurers that receive federal financial assistance to comply with Section 1557 nondiscrimination requirements;
- Defines sex discrimination as including discrimination based on pregnancy, related conditions, and pregnancy termination;
- Requires entities to give staff training on the provision of language assistance services for individuals with limited English proficiency and effective communication and reasonable modification to policies to accommodate people with disabilities;
- Requires covered entities to post notices of nondiscrimination along with a notice of the availability of language assistance services and auxiliary aids and services;
- Interprets Medicare Part B as federal financial assistance; and
- Refines the process for raising conscience and religious freedom objections
Public comments on the proposed rule are due 60 days after its publication in the Federal Register, or on October 3, 2022.
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