June 16, 2020
On Friday, June 12, the Trump administration issued a final rule that rolls back health care protections for lesbian, gay, bisexual, and transgender (LGBT) individuals. The U.S. Department of Health and Human Services (HHS) determined that sex discrimination does not include gender identity, sexual orientation, or sex stereotyping. However, the Supreme Court of the United States (SCOTUS) ruled on Monday, June 15 that the 1964 Civil Rights Act (Title VII) barring sex discrimination in the workplace protects LGBT employees from being fired because of their sexual orientation or gender identity. The SCOTUS ruling could have ramifications for the recent HHS regulation.
The final rule also reduces notice requirements related to information that health care providers and other entities must provide for individuals with limited English proficiency (LEP), eliminates the technical and training requirements for the use of video remote interpreting services for LEP individuals, and eliminates provisions related to discrimination on the basis of association with a protected class. The rule did not finalize a proposal to exempt entities with less than 15 employees from the requirement to provide appropriate auxiliary aids and services to people with impaired sensory, manual, or speaking skills.
ASHA’s 2020 Public Policy Agenda places a priority on advocating to ensure equitable and timely access to evidence-based services. Unfortunately, this final rule has the potential to negatively impact access to services for individuals that identify as LGBT and/or have LEP.
Section 1557 is the non-discrimination provision of the Affordable Care Act (ACA). In 2016, HHS issued a final regulation implementing Section 1557. In 2019, HHS revisited the rule and issued a Notice of Proposed Rulemaking that provided new interpretations of the law as it related to several provisions in the original final rule. ASHA provided comments on the 2019 NPRM [PDF] that highlighted concerns about the impact the proposed revisions could have on ASHA members as well as our members’ patients and clients.
Contact Daneen Sekoni, ASHA’s director of health care policy, health care reform, at firstname.lastname@example.org.