The Office for Civil Rights at the Department of Health and Human Services released a proposed rule on Section 1557 of the Affordable Care Act on September 8, 2015. Section 1557 prohibits discrimination on the basis of race, color, national origin (including immigration status and English language proficiency), sex, age, or disability in any program or activity receiving federal financial assistance or in any entity created under title I of the Affordable Care Act. This includes Medicaid, CHIP and QHPs operating in the federal and state-based Marketplaces, and is in addition to the separate ACA provisions that prohibit discriminatory benefit designs in any plan that must meet the Essential Health Benefit requirements.

Medicaid and CHIP are the ticket to health care for more than one-third of the nation’s children and are especially vital to young children (covering 45% of those under age six) and children of color (52% of Hispanic children and 54% of Black children). QHPs are an increasingly important coverage source for children too, with nearly one million children covered so far.

Section 1557 expanded on existing civil rights protections and took effect upon enactment of the Affordable Care Act back in 2010, but until the proposed rule was released last month, there were no regulations governing its enforcement. The proposed rule marks a big step forward to protect children and families from discrimination, but it could be strengthened. The proposed rule is complicated, referencing decades old civil rights laws in addition to the newer policies, but there are a couple of helpful resources to aid your understanding. The National Health Law Program’s September Health Advocate describes the history of the provision, outlines the proposed rule and offers some suggestions for improvement. The Kaiser Family Foundation also summarizes the proposed rule in an issue brief released last week.

We encourage you to take a look at the proposed rule and resources provided by NHeLP and KFF and consider how the rule addresses discrimination that children and families in your area face. Children could face discrimination in multiple ways, and it may manifest itself differently than it does for adults. Discrimination in health coverage and care prevents children and families from getting the care they need and contributes to disparities in health outcomes.

Does the proposed rule address the discrimination your community has experienced? If so, reinforce those provisions so that HHS knows they are important. It not, let HHS know how the rule could do a better job. Stumped by some provisions of the rule? Contact Mara Youdelman at NHeLP for assistance.

Comments are due November 9, 2015.