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Final 2024 Health Care Rights Rule

Last Friday, the Office for Civil Rights at the U.S. Department of Health & Human Services (HHS OCR) finalized changes to regulations implementing the Health Care Rights Law (HCRL), also known as Section 1557 of the Affordable Care Act. Justice in Aging applauds HHS OCR for restoring and further strengthening vital anti-discrimination and language access protections.

Older adults, especially people of color, immigrants, people with limited English proficiency (LEP), people with disabilities, and LGBTQ+ individuals, often face discrimination in health care settings that leads to poorer health outcomes. The HCRL and its implementing regulations are critical to preventing and redressing such discrimination.

The Biden Administration’s HCRL rule restores a foundation to empower older adults to know and realize their rights and to progress towards ending discrimination and addressing health inequities resulting from overt and structural racism, sexism, ageism, ableism, homophobia, transphobia, and xenophobia. In making these changes, HHS OCR cited a robust record of discrimination and health disparities, including the experiences of older adults. Highlights of the final rule include:

  • Restoring and improving notices that inform people of their right to language services and accessibility services at no cost. In 2021, Justice in Aging filed a lawsuit on behalf of Chinatown Service Center and St. Barnabas Senior Services, community-based organizations that provide social services to older adults with LEP, challenging the Trump Administration’s 1557 rule that eliminated the notice of rights and in-language tagline requirements. In restoring in-language notices, the Biden Administration’s final rule cites our lawsuit and discusses the importance of these notices to older adults with LEP:Litigants in Chinatown Services Center … raised specific concerns that older members of the Asian American, Native Hawaiian, and Pacific Islander community, who have high rates of limited English proficiency, experienced disparities because they are not aware of their right to receive language assistance services or how to raise a concern when such services are not provided.”
  • Removing barriers to seeking redress for discrimination based on age. First, the final rule explicitly recognizes that 1557 prohibits discrimination on the basis of intersecting identities, citing for example challenges faced by Latino older adults. Second, the rule removes barriers to filing and resolving Section 1557 administrative complaints based on age.
  • Prohibiting all Medicare providers from discriminating on the basis of race, color, national origin, age, sex and disability. The final rule establishes, for the first time, that Medicare Part B payments are a form of federal financial assistance subject to Section 1557, as well as Title VI, Title IX, Section 504, and the Age Discrimination Act.
  • Clarifying that LGBTQI+ individuals are protected by Section 1557’s prohibition against discrimination based on sex. Specifically, the final rule codifies in the regulatory text that sex-based discrimination includes sex characteristics, including intersex traits; pregnancy or related conditions; sexual orientation; gender identity; and sex stereotypes.

HHS OCR’s website has additional resources on the final rule, including a fact sheet available in 17 languages.

Justice in Aging is looking forward to working with HHS and our advocacy partners across the country to implement and enforce this rule and uphold the rights of older adults in accessing health coverage and services. We will provide additional analysis and HCRL resources for aging advocates in the coming weeks.

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