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Questions and Answers on Section 1557 of the Affordable Care Act

  1. Is HHS’ application of Section 1557 of the Affordable Care Act to discrimination based on gender identity and sex stereotyping a new policy? 

    No. HHS clarified that Section 1557 of the Affordable Care Act prohibits discrimination on the basis of gender identity and sex stereotyping.

    Section 1557’s nondiscrimination requirement applies to any health program or activity, any part of which is receiving federal financial assistance, or under any program or activity that is administered by an Executive Agency or any entity established under Title I of the Affordable Care Act or its amendments. OCR has enforcement authority with respect to health programs and activities that receive Federal financial assistance from the Department of Health and Human Services (HHS) or are administered by HHS or any entity established under Title I of the Affordable Care Act or its amendments.

  2. What is the statutory basis for this clarification?

    Section 1557 of the Affordable Care Act provides for federal nondiscrimination protection in the health care system, including on the basis of “sex.”  HHS clarified that this prohibition includes discrimination based on gender identity and sex stereotyping.  HHS intends to propose rules on section 1557 in the future, offering an opportunity for comment and input into this interpretation and others.

  3. What is the significance of “stereotypical notions of masculinity and femininity,” in HHS’s interpretation of Section 1557 of the Affordable Care Act?

    HHS has clarified that if people claim that they are not getting health care because of how they look, for example, they can file a complaint.  There will be no section 1557 regulation on the definition of what is masculine or feminine.

  4. Does this mean that transition related surgery is required to be covered by health insurers?

    No.

  5. How does HHS’ interpretation of Section 1557 apply to other federal departments?

    HHS’s interpretation applies in the context of the health care law under HHS authority.

  6. Will HHS offer further guidance?

    Yes, as HHS has said previously, the Department intends to issue further guidance on section 1557.

  7. Where can individuals interested in filing a complaint go for more information?

    If individuals think their rights have been violated, they can learn how to file a complaint with OCR at http://www.hhs.gov/ocr/civilrights/complaints/index.html.