On Monday, the Office for Civil Rights at the U.S. Department of Health & Human Services (HHS OCR) announced a new proposed rule implementing the Health Care Rights Law (HCRL), also known as Section 1557 of the Affordable Care Act. Justice in Aging applauds HHS OCR for taking this important step to restore and further strengthen vital anti-discrimination and language access protections that were gutted by the previous administration. 

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. In 2020, the Trump Administration gutted the HCRL regulations by removing notice of rights and in-language tagline requirements, eliminating anti-discrimination protections for LGBTQ+ people and other protected classes, limiting the scope of healthcare entities subject to the rule, and making it harder to challenge certain types of discrimination in court. 

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 LEP older adults, challenging the elimination of the notice and tagline requirements. The notice of proposed rulemaking (NPRM) released on Monday cites our lawsuit in discussing the harm that eliminating the taglines caused to LEP older adults and entities that serve them. In its proposal to restore in-language notices, HHS OCR states that “The Department believes that the provisions set forth in this NPRM would help restore consistency in language assistance procedural requirements and provide certainty to covered entities and consumers about what covered entities’ obligations are and what rights consumers have.”

We welcome this new proposed rule to start to reverse the harmful impact of the 2020 rule’s changes, which has stymied progress toward achieving equitable health care access and addressing disparities resulting from overt and structural racism, sexism, ageism, ableism, homophobia, transphobia, and xenophobia. HHS OCR is also proposing changes that further the HCRL rule’s protections, including broadening application of the rule to all Medicare providers and requiring staff training on language assistance, effective communication, and reasonable accommodations. In making these changes, HHS OCR cited to a robust record of discrimination and health disparities, including against older adults. We urge HHS OCR to efficiently finalize and enforce a robust final rule that fulfills the intent of the HCRL to end discrimination in health care.

During the proposed rule stage, the public has 60 days to provide written feedback on the changes HHS OCR is proposing, as well as recommend additional changes. Justice in Aging is looking forward to commenting on the NPRM and will provide updates and resources for aging advocates to engage in the rulemaking process on our HCRL webpage.