For Immediate Release: May 1, 2024
Contact: Jess Davidson at jdavidson@aapd.com; 202-975-0960
WASHINGTON, DC – On April 26, 2024, The Department of Health and Human Services (HHS) issued a final rule regarding section 1557 of the Affordable Care Act (ACA), which prohibits discrimination based on race, color, national origin, sex, age, or disability in covered health programs and activities.
“The American Association of People with Disabilities applauds HHS for publishing this long-awaited rule that revises Section 1557 and strengthens nondiscrimination protections for people with disabilities and other populations that have experienced discrimination and barriers when trying to obtain equal access to quality healthcare, said Michael Lewis, AAPD Vice President of Policy.
“Healthcare settings have a disproportionately large impact on disabled people’s quality of life. Healthcare settings are where medical practitioners and patients first establish disabled people’s diagnoses, define treatment and health management options, and ideally help improve disabled people’s quality of life. People with disabilities have a right to quality, accessible, and affordable healthcare and health insurance that is free of any type of discrimination so that we can live our most fulfilling lives,” said Maria Town, AAPD President and CEO.
“The protections established in this rule are especially meaningful because they provide protection not only for disabled people as a community but especially for multiply marginalized disabled people, such as disabled people of color or LGBTQ+ disabled people. Multiply marginalized disabled people are the most likely to face discrimination or substandard care when trying to receive healthcare. The protections in this rule are meaningful for LGBTQIA+ people, disabled people, Black, Indigenous, and people of color, pregnant and parenting people, older people, and more – a powerful reminder that disabled people are part of every single community, and our rights and protections should reflect that reality” Town continued.
The rule expands the application of 1557 rules to apply to all health programs or activities that receive HHS funding or are administered by HHS, including hospitals, health clinics, health insurers that participate in State insurance marketplaces or marketplaces that receive HHS funding, state Medicaid programs, and physicians’ offices that accept Medicare or Medicaid.
Specifically, the new rule:
- Extends the 1557 protections to health insurance issuers that receive Federal funds, including issuers that participate in federally funded and State health insurance Marketplaces;
- Clarifies that “discrimination on the basis of sex” includes discrimination based on sexuality, gender identity or expression, pregnancy or related conditions, sex characteristics (including intersex traits), and stereotypes. This provision updates the section 1557 rule to align with the Supreme Court’s 2020 decision in Bostock v. Clayton County, which held that Title VII of the Civil Rights Act of 1964’s prohibition on sex discrimination encompasses gender identity and sexuality;
- Requires effective communication and reasonable modifications for people with disabilities, which includes accessibility standards for buildings and facilities, as well as ensuring that health programs or services offered electronically (e.g., telehealth) are accessible for people with disabilities;
- Requires that all health insurance coverage and other health-related coverage be provided in the most integrated setting appropriate to people with disabilities, bringing section 1557 rules in line with the Supreme Court decision in Olmstead v. L.C.;
- Covered entities must provide and post notices informing patients of their civil rights under section 1557 of the Affordable Care Act, provide a process to file grievances, and designate an employee to coordinate compliance with the rule;
- Mandates that covered entities post notice of the availability of language assistance services and auxiliary aids are available free of charge to individuals with disabilities and limited English proficiency in prominent places on their website and within their facilities in the 15 most commonly spoken languages;
- Requires that entities take action to mitigate harm from the use of patient care decision support tools (such as Artificial Intelligence or algorithms) that use input factors such as color, national origin, sex, age, or disability, and;
- Mandates that covered entities provide staff training on implementation and compliance with these policies and procedures
AAPD looks forward to working with HHS to implement this regulation and continuing to work diligently to improve healthcare services for disabled Americans.
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