December 15, 2020

Recent Changes to the Definition of Sex Discrimination Under Section 1557 of the Patient Protection and Affordable Care Act

By Ima E. Nsien, Esq., Manatt, Phelps & Phillips LLP, Los Angeles, CA

Section 1557 of the Patient Protection and Affordable Care Act (PPACA) prohibits covered health programs from discriminating against individuals based on any of the grounds prohibited in various federal civil rights statutes.1 Those federal statutes include Title VI of the Civil Rights Act of 19642 (race, color and national origin), Title IX of the Education Amendments of 1972 (Title IX)3 (sex), the Age Discrimination Act of 1975,4 or Section 794 of Title 29 (disability). Section 1557 authorizes the Secretary of Health and Human Services to promulgate regulations to implement this Section. On June 19, 2020, the Department of Health and Human Services (HHS) issued a final rule (2020 Final Rule) implementing Section 1557,5 representing a significant departure from the regulations issued by the previous administration in 2016 (2016 Final Rule). The key changes span from the adoption of blanket abortion and religious freedom exemptions for healthcare providers6 to reducing protections for individuals with limited English proficiency.7

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