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New Proposed Rule Addressing Healthcare Accessibility on the Horizon

Department of Justice opposes current Section 1557 of ACA


Arundi Venkayya
Curator of EngagingPatients.org

In April, the Department of Justice came out against Section 1557 of the Affordable Care Act (ACA), deeming it unlawful. Portions of Section 1557 have been challenged in court — primarily because of issues of gender-identity discrimination and the termination of pregnancy — by several states and private plaintiffs. The Department of Justice has indicated that a new rule might soon be introduced that will potentially revisit language-access requirements and the scope of the rule in addition to gender-identity discrimination and pregnancy termination issues.

Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. The final rule on Section 1557 of the ACA was released in July 2016 and establishes standards for implementation.

Who is affected?

The final ruling applies to any health program or activity that receives funding from HHS including hospitals and/or health systems that accept Medicare and/or Medicaid; doctors who accept Medicare and/or Medicaid; health programs administered by HHS; Health Insurance Marketplaces; and health insurance and/or group health plans that participate in Health Insurance Marketplaces.

The final ruling:

  • Includes, for the first time, gender-identity discrimination within the definition of “sex discrimination” and extends protections against sex discrimination to health coverage and care
  • Codifies long-standing guidance regarding meaningful access to healthcare for individuals with Limited English Proficiency (LEP)
    • Specifically dictates that all organizations that receives Medicare and/or Medicaid dollars must notify people with LEP that they have the right to free, accurate and timely language assistance services
    • Dictates that these institutions must also provide these language assistance services
    • Dictates that these notifications and/or taglines must be printed in each state’s top languages on “significant communications” (e.g., brochures, posters, postcards)
  • Incorporates an existing law that requires organizations to notify patients and members of the availability of reasonable modifications, effective communication and readily accessible buildings and IT services to avoid disability-based discrimination
  • Prohibits health insurance benefits designed to discriminate and offers specific coverage protections for transgender patients and members

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