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HHS Will Enforce ACA’s Nondiscrimination Protections

The Department of Health and Human Services (HHS) will interpret and enforce section 1557 of the Affordable Care Act’s prohibition on discrimination “on the basis of sex” to include sexual orientation and gender identity.

These protections previously were narrowed in a rule finalized in June 2020 by the Trump administration. This rule removed protections for transgender and LGBTQ individuals and modified certain language assistance requirements for individuals with limited English proficiency (LEP). Unrelated to the HHS rule, the Supreme Court last summer ruled the Civil Rights Act’s prohibition on workplace discrimination on the basis of sex includes sexual orientation and gender identity.

Effective May 10, the HHS Office of Civil Rights will use this expanded definition of “on the basis of sex” as it processes complaints and conducts investigations related to discrimination.

This new announcement does not reverse the Trump-era rule. The administration noted it likely will release a new rule to address section 1557, but did not comment on the timeline or scope of such a rule.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Abigail Painchaud is a policy associate at America's Essential Hospitals.

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