Section 1557 of the Patient Protection and Affordable Care Act
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). The law prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities. Section 1557 builds on long-standing and familiar Federal civil rights laws: Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973 and the Age Discrimination Act of 1975. The Section 1557 statute extends nondiscrimination protections to individuals participating in:
- Any health program or activity, any part of which receives funding from HHS
- Any program or activity that HHS administers under Title I of the ACA, such as the Federally-facilitated Marketplace
- Health Insurance Marketplaces and all plans offered by issuers that participate in those Marketplaces.
Section 1557 has been in effect since its enactment in 2010 and the HHS Office for Civil Rights has been enforcing the provision since it was enacted.
If you believe you have been discriminated against on one of the bases protected by Section 1557, you may file a complaint with OCR.
Issuance of the 2020 Final Rule
Update (Feb. 1, 2021)
On January 19, 2021, the U.S. District Court for the District of North Dakota issued an order in the consolidated cases Religious Sisters of Mercy v. Azar, and Catholic Benefits Assoc'n v. Azar, No. 3:16-cv-00386, holding that the Religious Freedom Restoration Act, 42 U.S.C. §§ 2000bb et seq., entitles named plaintiffs to permanent injunctive relief from the provision or coverage of gender-transition procedures under Section 1557 of the Affordable Care Act, 42. U.S.C. § 18116(a), or any implementing regulations. The order may be found here:
Update (Sept. 15, 2020)
On October 15, 2019, the U.S. District Court for the Northern District of Texas issued an order in Franciscan Alliance, Inc. v. Burwell, No. 7:16-cv-00108, which vacated portions of HHS's 2016 rule implementing Section 1557. The order and accompanying decision may be found here:
On August 17, 2020, the U.S. District Court for the Eastern District of New York issued an order in Asapansa-Johnson Walker v. Azar, No. 1:20-cv-02834, staying portions of the 2020 Final Rule's repeal of portions of the 2016 rule and preliminarily enjoining HHS from enforcing the repeal of those provisions. The order may be found here:
On September 2, 2020, the U.S. District Court for the District of Columbia issued an order in Whitman-Walker Clinic v. HHS, No. 1:20-cv-01630, preliminarily enjoining HHS from enforcing portions of the 2020 Final Rule. The order and accompanying decision may be found here:
On October 29, 2020, the U.S. District Court for the Eastern District of New York issued an order in Asapansa-Johnson Walker v. Azar, No. 1:20-cv-02834, staying/enjoining additional portions of the 2020 Final Rule's repeal of portions of the 2016 rule. The order may be found here:
* People using assistive technology may not be able to fully access information in these files. For assistance, contact the HHS Office for Civil Rights at (800) 368-1019, TDD toll-free: (800) 537-7697, or by e-mailing OCRMail@hhs.gov.