By. Jocelyn Samuels
Director, HHS Office for Civil Rights
All across the country, the Affordable Care Act (ACA) is helping to make health care accessible to millions of people. In fact, six years after its passage, 20 million more Americans now have health care coverage thanks to the ACA. And we expect this number to grow as more people continue to seek quality, affordable care they need.
This week, as we kick off another Open Enrollment period for the Health Insurance Marketplace, it is important to remember that some individuals still face barriers while navigating the health care system; and we still have work to do to help them. We know that individuals with limited English proficiency (LEP) too often encounter discrimination and face linguistic barriers when seeking health care and coverage – the consequences can be dire for these individuals. These individuals are at risk of being misinformed, receiving the wrong type of care, or obtaining no care at all due to these language barriers.
It is important for health care providers to take the necessary steps to provide meaningful access to LEP individuals so they can communicate effectively with their health care providers and, as a result, improve their health outcomes. Here at the HHS Office for Civil Rights (OCR), we were thrilled to lead the charge earlier this year to further advance health equity for some of the most vulnerable communities across the nation.
In May 2016, OCR issued the final rule under Section 1557 of the ACA, taking a significant step towards equalizing access to healthcare for millions of individuals and their families. Section 1557 is the nondiscrimination provision of the ACA and it says that individuals cannot be subject to discrimination based on their race, color, national origin, sex, age or disability in certain health programs and activities. Consistent with longstanding principles under civil rights laws, this rule makes clear that the prohibition on national origin discrimination requires covered entities to take reasonable steps to provide meaningful access to LEP individuals who are eligible to be served or likely to be encountered within the entities’ health programs and activities. For the first time in history, these prohibitions extend to all entities that receive federal financial assistance from HHS; programs and activities that HHS operates itself; and the Health Insurance Marketplace and the issuers that participate in those Marketplaces.
This final rule under Section 1557 introduced enhanced protections for vulnerable populations and clarified existing language access requirements for LEP individuals. For example, reasonable steps might include the provision of language assistance services, such as oral interpretation or written translations.
In addition, all covered entities are required to post a notice of consumers’ civil rights, to let LEP individuals know about their right to receive in-language assistance, and to post taglines in the 15 languages spoken by LEP individuals in the states in which the covered entity operates, advising consumers of the availability of free language assistance services.
These protections for LEP individuals also extend to health insurance coverage. Section 1557 prohibits insurers from discriminating against individuals when providing or administering health-related insurance or other health-related coverage and in any marketing practices or benefit designs.
OCR has added a number of downloadable resources to our website to help individuals better understand their rights and to assist covered entities in taking steps to comply with Section 1557.
Here is what’s available on OCR’s website:
- General information on Section 1557 translated in up to 15 additional languages.
- Downloadable samples of the tagline and notice of nondiscrimination for covered entities to use in up to 64 languages.
- In-depth frequently asked questions on the compliance requirements under key provisions of Section 1557.
- Training materials on Section 1557 for health care providers and employees of health programs and insurance issuers programs.
We strongly encourage individuals and health care providers to visit our website to learn more about protections against discrimination in health care. It is our priority to ensure that LEP individuals are not denied access to the health coverage and services they need due to language barriers or discrimination.
OCR is committed to protecting the rights of LEP individuals and ensuring that covered entities comply with all the language access requirements under Section 1557.
If you believe that you have been discriminated against in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, you may file a complaint with OCR. You may file a complaint for yourself or for someone else. To learn more about nondiscrimination and health information privacy laws, visit OCR’s website at www.hhs.gov/ocr and you can follow us on Twitter at @HHSOCR!