On May 6th, 2024, the Department of Health and Human Services (HHS) issued a final rule under Section 1557 of the Affordable Care Act (ACA). Specifically, the HHS’s Office for Civil Rights (OCR) and the Centers for Medicare & Medicaid Services (CMS) drafted the rule. Chiefly, it advances protections against discrimination in health care. Earlier, in late 2023, the HHS adjusted Health Insurance Portability and Accountability Act (HIPAA) violation penalties.
Background of the Affordable Care Act (ACA)
Generally, the ACA is a comprehensive health care reform law enacted in March 2010. The ACA had 3 primary goals:
- Make affordable health insurance available to more people. The law provides consumers with subsidies that lower costs for households with incomes. These households, however, must fall between 100% and 400% of the federal poverty level (FPL).
- Expand the Medicaid program to cover all adults with income below 138% of the FPL. As of this blog post, not all states have expanded their Medicaid programs.
- Support innovative medical care delivery methods designed to generally lower health care costs.
Updates to Section 1557 of the Affordable Care Act
Emphatically, the HHS believes that the updates to Section 1557 strengthen protections against discrimination based on:
- race,
- color,
- national origin,
- sex,
- gender identity,
- sexual orientation,
- pregnancy-related conditions,
- age, and
- disability.
The final rule also reduces language access barriers, expands physical and digital accessibility, and tackles bias in health technology. Additionally, according to the HHS, the final rule restores the protections that were removed by the Trump Administration. Access to health care will also increase for underserved communities across the country. The Section 1557 final rule draws on extensive stakeholder engagement, including the review of over 85,000 public comments. The HHS also reviewed its enforcement experience and recent developments in civil rights law to draft the final rule.
Employer Takeaways
In conclusion, while much of the final rule mentions “covered entities, “employers who offer health care benefit plans should learn about these developments, which could impact their individual plans. This HHS-created fact sheet provides more information about the Section 1557 Final Rule. At this time, the fact sheet only includes summarized information on the recent changes to the Affordable Care Act. Employers who want a complete listing of the rule’s contents should read through the final rule. The effective date for the final rule is August 6th, 2024.