The ACA's Provision on Nondiscrimination Takes Shape.

Area of Science:

• Health Law
• Public Health Policy
• Civil Rights

Background:

• The Affordable Care Act (ACA) includes a nondiscrimination provision, Section 1557.
• Federal antidiscrimination statutes previously enacted form the basis for Section 1557's prohibitions.
• The Department of Health and Human Services (DHHS) is responsible for enforcing Section 1557.

Purpose of the Study:

• To analyze the newly issued regulations implementing Section 1557 of the ACA.
• To clarify the scope and application of nondiscrimination requirements in health programs.
• To examine the potential impact of these regulations on healthcare providers and patient rights.

Main Methods:

• Analysis of the text of the new DHHS regulations for Section 1557.
• Review of accompanying commentary from the DHHS Office of Civil Rights.
• Examination of existing federal antidiscrimination statutes and their relationship to Section 1557.
• Anticipation of judicial deference to DHHS regulations in discrimination lawsuits.

Main Results:

• The regulations establish standards for enforcement of Section 1557 by the DHHS.
• Courts are expected to defer to these DHHS regulations when interpreting Section 1557 in legal cases.
• Key issues addressed include the nature of rights under Section 1557, covered health programs, and prohibited grounds for discrimination.

Conclusions:

• Section 1557 regulations provide critical guidance on nondiscrimination in federally funded health activities.
• The interpretation of covered entities and prohibited characteristics, including sexual orientation and gender identity, is central to enforcement.
• These regulations signal a significant step in ensuring equitable access to healthcare services.