On October 15, 2019, the United States District Court of the Northern District of Texas issued a ruling that eliminated certain aspects of the Section 1557 nondiscrimination rule under the Affordable Care Act–primarily pertaining to the section on gender identity and termination of pregnancy.
The initial Section 1557 nondiscrimination rule issued by the Department of Health and Human Services (HHS) on May 13, 2016 focused on three rules prohibiting discrimination for all health programs and benefits federally funded or administered by the HHS. These rules were:
- Prohibiting discrimination in health care based on race, color, national origin, age, disability, and sex (including discrimination based on termination of pregnancy, gender identity, and sexual stereotypes).
- Enhanced language assistance for individuals who lack proficiency in English.
- Ensured effective communication to individuals with disabilities.
However, in August of 2016, a lawsuit was filed related to the Section 1557 rule claiming that it violates the Federal Administrative Procedures Act (APA), the Religious Freedom Restoration Act (RFRA), and protections under the United States Constitution. This led to the District Court of the Northern District of Texas on December 31, 2016, issuing an injunction upon Section 1557, blocking the discrimination protection on termination of pregnancy, gender identity, and sexual stereotypes from the bill. Though those rule provisions were blocked, the prohibition of discrimination in health care based on race, color, national origin, age, disability, or sex (other than gender identity and abortion) and enhanced language assistance for individuals who lack proficiency in English remained.
On July 10, 2017, the courts placed a hold on any further actions of the lawsuit, awaiting HHS to revise the Section 1557 parameters. On May 24, 2019, HHS released a revised Section 1557 rule which eliminated the “definitions” section of the rule, thus removing gender identity and termination of pregnancy from being included as “sex discrimination” and eliminating the requirement for health companies to provide nondiscrimination information in multiple languages for those who are not proficient in English. However, even though the aforementioned changes were released by HHS the Section 1557 provisions on gender identity and abortion still remained in place while the Section 1557 rule was in litigation. Ultimately, on October 15, 2019, the court ruled that the Section 1557 provisions on gender identity and abortion be unenforceable while HHS revises the sex discrimination provision of Section 1557 and will revisit once a revised rule is finalized.
Read the ACA Compliance Bulletin for more details.
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