The Trump Administration has once again blatantly attacked the civil rights of low-income older adults who are LGBTQ, limited English proficient (LEP), and others who experience discrimination in health care in our country. Last week, the U.S. Department of Health & Human Services (HHS) Office for Civil Rights finalized dangerous and far reaching changes to regulations implementing the Health Care Rights Law, also known as Section 1557 of the Affordable Care Act, which prohibits discrimination on the basis of race, color, national origin, sex, age, and disability in health programs and activities receiving federal financial assistance.
The new rule attempts to eliminate protections for LEP individuals and the rights of LGBTQ people, despite today’s U.S. Supreme Court decision applying Title VII’s sex discrimination prohibitions to LGBT employees. It also attempts to significantly limit the way that victims of any type of discrimination can seek redress under the law. The rule guts enforcement of the only federal law designed to protect against discrimination in health care.
As the COVID-19 pandemic continues to kill people of color, especially older adults and those with disabilities, at disproportionate rates due to the systemic racism that pervades both our health care system and other aspects of life, rolling back these protections is both a racist and dangerous decision. In issuing these changes, the HHS Office for Civil Rights is defying its mandate and profound duty to protect the civil rights of these communities.
Most importantly, this is a cruel, extremist, and transparent political attack on older adults and people with disabilities who are LGBTQ and/or LEP. Because older adults have lived experiences at the intersection with other identities, an attack on the rights of LGBTQ and LEP older adults is an attack on older adults of color:
- Nearly 3 million individuals 50 years old or older identify as LGB, and projections indicate this could rise to nearly 7 million by 2030.
- LGBT identification is higher among women and people of color, and LGBT immigrants of color are more likely than white LGBT immigrants to experience discrimination while receiving health care services and to receive substandard care.
- Almost 50% of LGBT individuals who lived in or had a loved one in a long-term care facility report experiencing mistreatment.
- Over five million older adults across the country are LEP; more than 2 out of 3 Chinese, Korean, Vietnamese, Laotian, Hmong, Fijian, Marshallese, Nepalese, Taiwanese, Bangladeshi, and Burmese older adults are LEP.
- Patients with limited English proficiency experience high rates of medical errors with worse clinical outcomes than English-proficient patients and receive lower quality of care by other metrics.
Justice in Aging is committed to fighting for robust enforcement of the Health Care Rights Law and calls on this Administration to reverse course, restore the critical protections it took away, and be a defender of civil rights.