HHS Proposes New Rules to Prevent Discrimination in Health Care

Last week, the federal government, for the first time, announced far-reaching regulations banning discrimination in health care. With this historic action, the government is prohibiting discrimination in the provision of health care services based on sex and gender identity. The new regulations announced by the Office of Civil Rights (OCR) in the Department of Health and Human Services (HHS) also expand existing discrimination bans on the basis of disability or health status, race, national origin, age, or language spoken.

Rules address widespread discrimination in health care

Congress passed the Affordable Care Act (ACA) not only to reduce the cost of health care but also to improve access to care for everyone, regardless of their identity or life experience. Unfortunately some communities continue to experience barriers in obtaining health insurance and getting the care they need with dignity and respect.

The HHS regulations, long awaited by Families USA and other advocates, implement Section 1557 of the Affordable Care Act that prohibits discrimination. This provision of the law builds on existing anti-discrimination laws, such as Title IV of the Civil Rights Act of 1964, to expand their reach. It’s been two years since HHS first requested information about implementing Section 1557, back in August of 2013.

While these anti-discrimination standards have technically been in effect since the passage of the ACA in 2010, once fully implemented through these enforcing regulations, Section 1557 will set out clear standards forbidding discrimination in health care.

Advocates have reported a wide variety of potentially discriminatory practices that this rule could help prevent, including:

• Doctors refusing to treat patients because of their gender identity. In one survey, 70 percent of transgender respondents said they had experienced discrimination from a health care professional.
• Insurers structuring plans to discourage certain populations from accessing them, such as making HIV/AIDS drugs more expensive.
• Hospitals refusing to treat individuals who do not speak English.
• Insurers and employers not covering maternity care – which is often expensive – for women covered as dependents.
• Plans designing marketing materials to be more appealing to certain populations and less to others.

Many health insurers and health care providers affected by new rules

These new rules apply to entities receiving federal funding such as hospitals, clinics, navigators, and insurance companies offering plans through ACA marketplaces. They also apply to public insurance programs like Medicare, Medicaid, and CHIP, and to the health care marketplaces themselves. State agencies must also comply. These protections can be enforced either through legal action by discriminated individuals or through oversight by OCR.

Many other health and civil rights groups cheered the announcement, including the National Partnership for Women and Families, Center for American Progress, and Asian and Pacific Islander American Health Forum.

By releasing these new proposed rules, HHS is pushing the American health care system toward greater health equity.  It is important that advocates take advantage of this historic opening to advance health justice and review and comment on these new regulations by the November 6 deadline.