The National Partnership for Women & Families, which has been working for 45 years to stop discrimination and improve women’s health, yesterday submitted comments praising the robust nature of the Section 1557 Nondiscrimination in Health Programs and Activities proposed rule and offering recommendations to further strengthen the regulations. A landmark provision, Section 1557 of the Affordable Care Act (ACA) marks the first time that federal civil rights law has prohibited discrimination on the basis of sex in health programs or activities, and it significantly expands protections for individuals seeking and receiving health care.

In its comments, the National Partnership commends the Obama administration for including strong protections against discrimination in health care coverage, access and treatment based on sex stereotypes, gender identity, pregnancy and childbirth, race, color, national origin, disability and age. The letter details the tremendous value of provisions that will:

• Apply anti-discrimination protections to a broad array of entities that receive any form of federal assistance, including health care providers, hospitals, clinics, community health centers, insurers and health insurance marketplaces, among others;
• Specifically and definitively protect individuals from discrimination based on gender identity, gender expression, gender transition, transgender status or sex-based stereotypes;
• Require non-discriminatory benefit design and marketing; and
• Help ensure individuals with limited English proficiency can access and understand information relevant to their health care.

“Discrimination in health care causes grave harm to women and threatens their health. It can also result in lower quality care and higher costs, which directly undermine national efforts to deliver higher quality, higher value health care,” said Judith L. Lichtman, senior advisor at the National Partnership. “Robust implementation of the Section 1557 regulations through careful monitoring and enforcement has the potential to reduce the pervasive discrimination that jeopardizes women’s health.”

In its letter, the National Partnership strongly opposes inclusion of a religious exemption in the final rule, noting that religious refusals are incredibly harmful to women’s health and undermine their dignity and equality. Refusals have been used to withhold important information and even deny care. The National Partnership urges the administration to instead use Section 1557 to address the discriminatory impact of refusals that are already in place.

In the letter, the National Partnership also recommends the following changes, among others:

• A clarification that Section 1557 also protects employees from discrimination by their employers, consistent with protections in existing civil rights law;
• Clearer language on protections for pregnant women, including ensuring that pregnant dependents have access to maternity care; and
• Expanding protections related to health information technology, to ensure that they apply not only to discrimination based on disability, but also to discrimination based on race, color, national origin, sex and age.

The National Partnership’s comments are available here.