ACA Section 1557 as a Tool for Anti-racist Health Care

By Jamille Fields Allsbrook and Katie Keith

The Affordable Care Act (ACA) has undeniably narrowed racial and ethnic health disparities by reducing the uninsured rate and improving access to care for people of color. But significant gaps persist, driven in no small part by structural racism. Section 1557 of the ACA prohibits discrimination in health coverage and care by expanding protections in federal civil rights laws.

In a new piece for Health Affairs Forefront, Jamille Fields Allsbrook and CHIR faculty Katie Keith discuss how the Biden administration can use its existing authority under Section 1557 (and Title VI of the Civil Rights Act) to better ensure anti-racist health care and insurance. The post describes some of the health disparities experienced by people of color and explains how Congress used Section 1557 to build on Title VI. The authors then provide recommendations for how federal officials at the Office for Civil Rights can better leverage Section 1557 as a tool to advance racial justice. Examples include:

  • Identifying benefit and network designs that discriminate based on race;
  • Imposing affirmative obligations on covered entities (such as ensuring that algorithms are not biased or discriminatory);
  • Requiring the collection and reporting of demographic data;
  • Taking targeted enforcement action; and
  • Conducting a compliance review initiative focused on maternal health disparities.

You can read the full piece here.

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The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.