Discrimination in Health Care: Section 1557 and the Protection of Our Rights

Action Center   ➞   Issue Tracker   ➞  Health Care  ➞  Section 1557

Notice, PLEASE READ FIRST: The current administration has recently attempted to rewrite and gut Section 1557’s critical regulations so that they no longer protect us all. ASAN has written a statement opposing these unjust changes. They are currently being sued by several prominent civil rights organizations.

The Supreme Court has also spoken on a very similar issue and found that discrimination on the basis of sex did explicitly include sexual orientation and gender identity. The fight for our rights is not over. Therefore: This page refers to the regulations as they were before the Final Rule’s publication.


The Patient Protections and Affordable Care Act is a law that was passed in 2010. People call it the Affordable Care Act (ACA). Some people also call it Obamacare, because Barack Obama was the President who helped make the law. “Obamacare” and the Affordable Care Act (ACA) are the same thing. 

The ACA made it easier for people to get health insurance. Health insurance helps you pay for health care. ASAN wrote an Affordable Care Act Toolkit for Self Advocates that gives you more information. You can read it here. 

The ACA has a lot of different sections. Section 1557 of the ACA says that health care providers and insurance companies can’t discriminate. It says health care providers and insurance companies can’t discriminate based on: 

  • Race
  • Color
  • National origin
  • Sex
  • Age, or 
  • Disability. 

Section 1557 protects people that were not protected against discrimination in health care before, like LGBTQ people. It also requires that information about health care be accessible, which is important for people with disabilities and people who speak English as a second language. 

This section will talk about what Section 1557 does and why it is important. It will also talk about what the regulations for Section 1557’s and why they are important. The section will also talk about how some people want to change Section 1557 and its regulations, and what you can do to protect it. 

What Section 1557 Does

Before the ACA, insurance companies could choose not to pay for health care for a person based on who they were. For example, if a health insurance plan usually covered cancer treatments, they could choose not to pay for cancer treatments for someone with a history of cancer. If a health insurance plan usually would pay for HIV screenings, they could decide not to pay for those screenings for someone who is transgender. Both of these examples are discrimination. Discrimination made it harder for people to access the health care they needed.

The ACA made it so that insurance companies have to pay for the same services for everyone using the same insurance plan. They can’t choose to not pay for someone because of things like their gender, race, sexual orientation, or disability status. 

This also applies to health care providers, like doctors. Health care providers can’t choose not to give someone medical care because of who they are. They also can’t decide to treat people differently – like giving them worse health care or not giving them the same treatment – just because of who they are. They need to treat everyone fairly.

Section 1557 applies to any health care program that gets money from the US government. Since most hospitals and clinics are getting some money from the US government, they are usually covered. Insurance companies also usually get money from the US government. 

What Section 1557’s Regulations Do 

Regulations are rules government agencies make about how to follow a law. The regulations for 

Section 1557 explain how health insurance companies and health care providers can follow Section 1557. For example, the regulations are even more specific about what counts as discrimination. 

Section 1557 says that discrimination based on sex is illegal. The regulations for section 1557 go into more detail. The regulations say that discrimination based on sex includes discrimination based on:

  • Gender
  • Gender identity
  • Pregnancy
  • Stereotypes about sex

In other words, the regulations say that section 1557 applies to people who are LGBTQ.

This part of the regulations is really important for a lot of people with disabilities. This is because a lot of us are LGBTQ or don’t match stereotypes people have about men and women. 

Another example is communication. Section 1557 says that information insurance companies or health care providers give you has to be understandable. The regulations for Section 1557 go into more detail. The regulations say that:

  • Communication with people with disabilities has to be as good as communication with people without disabilities. Bad or limited communication will not do. 
  • Doctors and insurance companies have to give people with disabilities anything we need to communicate with them, like sign-language interpreters or telephone relay services. 
  • They also have to let us know in writing about our right to communicate

Doctors and insurance companies also have to make sure that people who do not know English very well can access health care. 

  • They have to provide translations of documents and statements they make into any language that someone needs.
  • They need to provide interpreters so people can talk to their doctors.
  • They have to create papers in the top 15 most common languages besides English in the area stating that interpreters are available. This lets people know about their right to communicate.

The regulations for Section 1557 are very important. They make sure the law covers all of the people it needs to.

How You Can Help Protect Section 1557 

Here are some ways you can protect the rules in Section 1557: 

  • Comment on proposed rules that would change Section 1557 or its regulations. Tell HHS why its current changes are unjust! When the federal government wants to change a rule, they have to give everyone a chance to comment. We need you to tell the government why Section 1557 is important for people with disabilities!
  • Tell your members of Congress why allowing religiously-motivated discrimination in healthcare puts people with disabilities at risk. It is important that your members of Congress hear from you about why you need Section 1557. You can contact your Senator or your Representative. ASAN’s Civic Engagement Toolbox For Self-Advocates tells you how to contact your Members of Congress.