Section 1557 of the Affordable Care Act was finalized on May 18, 2016, and will be coming into effect two months from that date on July 18, 2016. However, any changes to health insurance and group plans will not be required to go into effect until January 1, 2017. The law applies to a wide range of health care and health insurance entities that receive federal financial assistance. The section, titled “Nondiscrimination,” provides a breakdown of previously understood definitions of anti-discrimination with a few additions.
The final rule states:
“An individual shall not, on the basis of race, color, national origin, sex, age, or disability, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any health program or activity to which this part applies.”
While that may seem like previously understood language, with regard to the Affordable Care Act, it’s been questioned about where Section 1557 applies within specific health programs. This is especially necessary to define in terms of gender and disability, as the latter includes changes to the quality of accessibility for the disabled. Those with difficulties speaking English are also included.
Commenters have questioned where immigration status falls within understanding an individual’s national origin and rules governing that form of discrimination. The HHS’s response is as follows:
“An individual’s national origin is not the same as her citizenship or immigration status, and neither Title VI nor Section 1557 explicitly protects individuals against discrimination on the basis of citizenship or immigration status. However, as under Title VI, Section 1557 and this part protect individuals present in the United States, whether lawfully or not, who are subject to discrimination based on race, color, national origin, sex, age, or disability.”
Additionally, religion was brought into question, and while Section 1557 does not have clearly defined rules surrounding discrimination by religion, the HHS replied that standard federal rules regarding religious freedom would be exercised.
Section 1557 applies to state-based Marketplaces and those facilitated by the federal government, as well as HHS-administered health programs and activities, and those health programs and activities that are provided any federal financial aid through the HHS—including loans, credits, grants, and other forms of assistance.
While the HHS received many comments and suggestions for improving Section 1557, the final rule is clear in its intent that nondiscrimination will be exercised within health programs from the scope of their service (i.e. whom they are servicing) as well the health plans offered to their employees. It’s a practice that many have already exercised in other facets of their companies. However, with regard to health programs being funded by the HHS, the anti-discriminatory language now includes some much-needed clarification.
To read the details of Section 1557, click here.
