ACA Nondiscrimination Rules for Health Programs and Activities (ACA Section 1557)

Summary

This practice note addresses Section 1557 of the Patient Protection and Affordable Care Act (Pub. L. No. 111-148) (ACA). Section 1557 prohibits health programs and activities that are (1) federally funded (which includes most practitioners and hospitals and many insurers) or (2) administered by the Department of Health and Human Services (HHS) or an ACA Title I entity (e.g., ACA exchanges) from discriminating against individuals based on protected characteristics under major federal antidiscrimination laws, including race, color, national origin, sex, age, and disability. HHS finalized Implementing regulations in 2016. 81 Fed. Reg. 31,376 (May 18, 2016)) (2016 Final Rules). In 2020, the Trump Administration HHS overhauled the 2016 Final Rules, significantly narrowing their scope and effect. 85 Fed. Reg. 37,160 (June 19, 2020) (2020 Final Rules). In August 2022, the Biden Administration HHS proposed to modify the rules again, restoring many aspects of the original regulations and ...