National Health Law Program Condemns Administration for Encouraging Discrimination in Health Care
Washington, D.C. – After years of executive orders and unrelenting sabotage undermining the landmark Affordable Care Act, the Trump administration has moved to officially rollback the vital regulations implementing ACA’s nondiscrimination protections for people historically discriminated against in our health care system. NHeLP views this move as particularly heinous against the backdrop of a pandemic disproportionately impacting people of color and escalating racist violence targeting Black communities.
The ACA’s Section 1557 prohibits discrimination in health care programs based on race, color, national origin, language proficiency, sex, sex stereotypes, gender identity, age, or disability. Under the Obama administration, these safeguards were robustly implemented and, for the first time, provided critical anti-discrimination protections against discrimination on the basis of sex and gender identity in health care. It also provided strong protections for people with disabilities or limited English proficiency. Trump’s team at the Department of Health and Human Services has worked tirelessly to pull back those protections.
The rule change rolls back notice and language access requirements for individuals with limited English proficiency. “All individuals need to know they are protected by Section 1557 and what to do when they face discrimination. Eliminating tagline and notice requirements shifts the onus from providers who are prohibited from discriminating to individuals to somehow figure out their rights and how to enforce them. Health care is already an unequal playing field and the administration’s efforts continue to tilt the scale further against patients,” said National Health Law Program Managing Attorney of the D.C. office Mara Youdelman. “The COVID-19 pandemic has revealed how important language access is for patient care. The inability of patients to communicate with medical staff can be deadly and exacerbates existing health inequities. When data shows that COVID-19 is already disproportionally impacting Black and Latinx communities, why would the administration pour time and effort into erecting new barriers to care?”
Its choice to finalize this rule now—as Black women and their families across the country fight for survival amid the pandemics of COVID-19, police violence, and Black maternal mortality—is a condonation of all the above
In addition to targeting people with limited English proficiency, the rule change also seeks to gut protections for people seeking reproductive and sexual health care. “Sex discrimination is deeply entrenched in our health care system. It is particularly harmful to women who suffer compounded discrimination at the intersection of multiple identities, including Black, Indigenous, Asian, and Latinx women, trans individuals, and women with disabilities,” says Madeline Morcelle, a staff attorney and member of NHeLP’s Reproductive and Sexual Health team. “Until the ACA, women were charged more for insurance and were denied coverage for essential care, such as contraception and maternity care. The ACA’s Section 1557 explicitly prohibits those practices and was the first federal law to prohibit sex discrimination in health care. By rolling back regulations implementing these protections, the Trump administration’s rule privileges a narrow set of religious beliefs over the health and lives of living, breathing women. Its choice to finalize this rule now—as Black women and their families across the country fight for survival amid the pandemics of COVID-19, police violence, and Black maternal mortality—is a condonation of all the above.”
“Since taking office, the Trump administration has actively targeted the LGBTQ community and worked to undermine the legal protections we rely upon. Today’s final rule is intended to intimidate transgender and gender non-conforming people, and make it more difficult to access health care,” said senior attorney Wayne Turner. “Providing health care providers license to discriminate and turn away patients is unconscionable in the best of times, but nothing short of barbaric in the middle of a deadly pandemic. The cruelty isn’t an unfortunate side effect. The cruelty is the point.”
For additional comment or more information about our work, please contact NHeLP’s Director of Communications Andy DiAntonio at [email protected] or 703.615.0786.