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Wait, There Wasn’t a Law Against That Already? Section 1557: a Title IX for Health Care

Strong federal protections against sex discrimination exist in the workplace and in schools, and have existed, for sixty and forty years, respectively. Of course, there’s a lot of work to do to enforce those protections and build on them. In health care, no such broad antidiscrimination law existed.

You may need to re-read that. People generally do a double-take when they hear there has been no big prohibition against sex discrimination in health care until just 3 years ago. “Did I really read that right??” You did.

We needed a Title IX, the federal law that prohibits sex-based discrimination in education program, for health care. Finally, now, we got one!

Section 1557 of the Affordable Care Act (Obamacare) adds this important protection against sex discrimination in health care. But, that’s not all.

For one, Section 1557 expands existing protections against discrimination in the health care area based on race, color, national origin, disability, and age. Specifically, the law protects individuals from discrimination based on race, color, national origin, sex, age, disability, gender identity, and sex stereotypes in:

  • the health programs or activities of recipients of federal financial assistance, like all operations of a hospital or the health plans of entities that receive federal grants;
  • federally-administered programs, such as Medicare or the Federal Employee Health Benefit Plan; or
  • any entity established under Title I of the ACA, including the health insurance exchanges being established in the states—the places people will go to compare their options for and purchase health insurance

Or, put more simply: the law’s reach is broad and impacts virtually all aspects of health care.

Second, the Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS), which has the authority and obligation to enforce the law, has already made clear that Section 1557’s sex discrimination protection means that discrimination based on gender identity or sex stereotypes is prohibited.  

The law is enforced by OCR at HHS, which resolves administrative complaints filed under Section 1557. This means that individuals who believe they have been discriminated against in a covered health program can file a complaint with OCR or that others can do so on their behalf. Again, this is similar to the way in which Title IX is enforced. And, like Title IX, Individuals can also go directly to court to secure an order that the discrimination stop and to ask for any damages to compensate them from the injuries suffered as a result of the discrimination.

Our protections against sex discrimination are now a triple threat: in employment, education, and –finally—health care.