Biden Administration Finalizes Updates to Regulations Implementing the Affordable Care Act’s Protections Against Health Care Discrimination

Biden Administration Finalizes Updates to Regulations Implementing the Affordable Care Act’s Protections Against Health Care Discrimination

Washington, DC—Today marks a significant milestone in health care equity as the Biden administration has finalized changes to the regulations governing Section 1557 of the Affordable Care Act (ACA). These revisions, aimed at fortifying and reinstating nondiscrimination regulations, champion protections from health care discrimination for underserved communities.

The National Health Law Program helped craft Section 1557 as part of our work on the ACA and we have continued to fight for its full implementation. We celebrate the Biden-Harris administration’s robust implementation and enforcement of Section 1557’s protections. Discrimination has no place in health care, and we continue our work to secure access to care, free from any discrimination or prejudice. 

Key Achievements of the Implemented Changes:

Ensuring Language Access and Protections for People of Color: Section 1557 ensures that individuals with limited English proficiency (LEP) have access to vital health care information. Health care entities are required to provide language services, breaking down language barriers for diverse communities. Further, they cannot discriminate on the basis of race.

“We support the Office for Civil Rights’ efforts to ensure people of color and limited English proficient individuals do not face discrimination when accessing health care”, said Mara Youdelman, Managing Director for Federal Advocacy at the National Health Law Program. “For decades, too many individuals have been left behind as health disparities increase. These new regulations will help ensure that all individuals in the United States have effective legal protections to prevent discrimination. Without prohibitions on racial discrimination or requirements for effective language services, people of color and LEP individuals often face insurmountable barriers to accessing needed care and services.”

Championing Protections Against Sex Discrimination: Section 1557 was the first federal law to prohibit sex discrimination in health care, which includes discrimination related to sex stereotypes, sex characteristics (including intersex traits), gender identity, sexual orientation, and pregnancy (including abortion) and related conditions. The Biden-Harris administration’s regulatory changes clarify the law’s protections, providing a comprehensive shield against sex discrimination.

“After the Supreme Court overturned the constitutional right to abortion, longstanding discriminatory barriers to health care only intensified for women and people capable of pregnancy, and especially people of color, people with chronic health conditions, and immigrants. The Office for Civil Rights’ new regulations take essential measures to clarify protections against sex discrimination in a sexual and reproductive health care context and beyond,” said Madeline Morcelle, a senior attorney at NHeLP. “But our work is not done. We will fight to ensure that low-income and underserved communities around the country understand their rights and what to do when they are violated.”

The implemented changes strengthen protections for LGBTQI+ individuals. These revisions protect the right to health care free from prejudice and discrimination, addressing specific concerns related to gender-affirming care and hormonal replacement therapy.

“Many LGBTQI+ people experience the pain of discrimination from the very people who should be providing care. This Final Rule recognizes that health care discrimination is not only wrong, it is unlawful,” said Wayne Turner, a senior attorney at NHeLP. “The previous administration sought to exempt most private health insurers from the Affordable Care Act’s nondiscrimination requirements, contrary to the plain meaning and intent of the law. We welcome the Biden-Harris administration’s efforts to hold health insurance companies accountable for ongoing discriminatory practices.”

Ensuring Access and Services for People with Disabilities: Section 1557 helps ensure that health care programs and services provide physical access, effective communication, and community integration. The regulatory changes also affirm that people with disabilities are shielded not only from coverage rejection but also from discriminatory pricing practices, including co-pays, prescription tiering, and coverage limits.

“For too long, people with disabilities have faced discriminatory practices in health care coverage and services. This discrimination shows up in the form of inaccessible facilities and equipment, failure to provide sign language interpreters and other auxiliary aids and services, health care apps that cannot be used by all, exclusionary insurance practices, and unnecessary segregation. The new rule is an important step forward towards achieving the goal of nondiscrimination and health equity for disabled people,” said Jennifer Lav, Senior Attorney.

This milestone achievement reflects the unwavering commitment of the Biden-Harris administration to eradicate discrimination from our health care system. The rule’s finalization is a testament to the collaborative efforts of advocates, policymakers, and health care entities dedicated to fostering an inclusive and equitable health care landscape for millions of people.

We are reviewing the final rule and our legal and policy staff are available for interviews. Reporters interested in speaking with the team at the National Health Law Program should contact Andy DiAntonio at [email protected].

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