HHS Proposes Protections to Reduce Discrimination, Disparities in Healthcare

A newly proposed rule from HHS would assist vulnerable populations gain equal access to healthcare and health coverage. The Nondiscrimination in Health Programs and Activities rule will extend all civil rights obligations to the health insurance marketplaces and HHS health programs and activities.

A section of the Affordable Care Act (ACA) already extended civil rights protections banning sex discrimination to health programs and activities, and the proposed rule establishes that the prohibition on sex discrimination includes discrimination based on gender identity.

“This proposed rule is an important step to strengthen protections for people who have often been subject to discrimination in our health care system,” HHS Secretary Sylvia M. Burwell said in a statement. “This is another example of this administration’s commitment to giving every American access to the health care they deserve.”

In addition to the insurance exchanges and HHS programs and activities, the rule encompasses any programs or activities that receive any funding from HHS, such as hospitals accepting Medicare patients or physicians who treat Medicaid patients.

Under the ACA the Office for Civil Rights has been accepting complaints, but this proposed rule makes it clear that individuals who are victims of discrimination can seek legal remedies. The rule bars issuers on the exchanges from marketing practices or benefit designs that discriminate on the basis of race, color, national origin, sex, age, or disability.

Among the new protections included in the proposed rule:

• Women must be treated equally with men in the healthcare they receive. They cannot be charged more than men and they are protected from discrimination not only in the health coverage they obtain, but in the services they seek from providers.
• Individuals may not be subject to discrimination based on gender identity. Insurance policies cannot contain categorical exclusions on coverage of care related to gender transition.
• There are new requirements for individuals with limited English proficiency so that they are able to communicate effectively with providers in order to describe their symptoms and understand their treatment.
• Individuals with disabilities should have access to auxiliary aids and services, such as alternative formats and sign language interpreters.