Illinois joins coalition supporting restoration of anti-discrimination protections under Affordable Care Act

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Illinois Attorney General's Building in Springfield. Photo by Tom Wray
The Illinois Attorney General's building in Springfield. Photo by Tom Wray

Illinois Attorney General Kwame Raoul on Tuesday joined a coalition of 22 attorneys general in a comment letter supporting the Department of Health and Human Services’ (HHS) proposed rule strengthening anti-discrimination protections under the Affordable Care Act (ACA).

The proposed rule would implement Section 1557 of the ACA, which prohibits health care programs, benefits and services from discriminating on the basis of race, color, national origin, age, disability or sex (including pregnancy, sexual orientation, gender identity and sex characteristics). 

“At a time when some states are rolling back rights to reproductive and sexual health care, it is more important than ever that people can access needed health care services without the fear of discrimination,” Raoul said in a statement. “I appreciate the Biden administration’s commitment to prohibiting discrimination in health care, and I will continue to fight any attempts to weaken the Affordable Care Act’s promise of quality health care services for millions of Illinoisans.”

The coalition argue the rule is critical to safeguarding the health and well-being of communities of color, people with pregnancy-related conditions, LGBTQ individuals, people with limited English proficiency and those with disabilities.

Implemented in 2016, Section 1557 prohibits discrimination in federal health care programs, benefits and services. Specifically, it prohibits discrimination on the basis of race, color, national origin, sex, age or disability.

The provision was undermined in 2020, when HHS finalized a rule rolling back those protections under the Trump administration. Now, HHS has invited comments on a proposed revision that would restore comprehensive anti-discrimination protections to the ACA.

In their letter responding to HHS’ notice, Raoul and the coalition assert their support for the proposed rule because, among other reasons, preventing a broader group of entities from discrimination in the health care system will reduce adverse health outcomes, the costs of which would otherwise be borne by the states’ public health systems. Also, limiting the scope of Section 1557 increases the burden on the states to monitor and enforce nondiscrimination laws. 

Raoul and the coalition applaud the rule for preserving and broadening the following protections:

  • Prohibiting sex discrimination based on gender identity, including against transgender people.
  • Establishing language access requirements to ensure people of all national origins, including those with limited English proficiency, have meaningful access to health programs and activities.
  • Prohibiting discrimination on the basis of pregnancy-related medical conditions, such as past pregnancy and the termination of pregnancy.
  • Recognizing that the prohibition on discrimination in healthcare encompasses algorithms and other automated clinical decision-making tools.
  • Clarifying, for the first time, that Section 1557 prohibits discrimination in telehealth services.

Joining Raoul in filing the comment letter are the attorneys general of California, Connecticut, Delaware, the District of Columbia, Hawaii, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont and Washington.

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