Fed Regulation 9- ACA Section 1557 Flashcards
ACA Act Section 1557
An individual shall not be excluded from any health program or activity, receiving Federal Financial assistance, or any activity administered by an Executive Agency. Health insurances can no longer deny you because of preexisting conditions and other reasons.
6 Questions
(1) What class or classes are protected?
Title IX →Sex. Per Bostock, it’s unclear whether sex extends to sexual orientation or transgender status. Depends what administration interprets the law via notice and comment rulemaking
Title VI → race, color national origin
Age Discrimination Act: age
Federal Rehabilitation: disability
Where do we look if it’s not in the statute? → Agency interpretation!
Could Congress have worded this differently? → they could have enumerated the protected classes, they could have just made it super board “any person who is treated differently other than by virtue of their healthcare needs has a cause of action
(2) What else is required for protection to apply ?
Any health program or activity receiving federal financial assistance
(3) Who is obliged to comply with protection ?
Any federally funded health program
Private insurers: yes, they are giving them tax credits
Private physicians: probably, if they are taking Medicare part B payments.
(4) Is there a private right of action?
Yes.
Uses the same “individual language” but depends on what grounds you are suing under
(5) Can a private plaintiff bring a claim under a disparate impact theory?
Two ways to look at it:
We bring all the statutes mentioned in this statute and using those individual tests, determine if there is a disparate impact claim for private plaintiffs
No matter what grounds someone is suing on, it’s all the same but it depends how it’s interpreted. “On the grounds” = “but for” / preponderance standard
(6) What test for caution is used?
Depends what grounds you are suing under
Caselaw:
Rumble v. Fairview: unified standard.
Doe v. CVS: each individual provision imports it’s own standards.
Policy for ACA
If we are treating each standard differently, what if someone who holds 2 statuses under this statute is suing. How do we treat that in a single case?
Positives: if you bring a case on race, maybe you don’t have to meet the stringent standard of Section 504. Continuity is good, we have all these statutes over the course of MANY decades and now we have a rule. Section 1557 is a good thing because it’s the first health context statute. It’s expansive, it covers private insurers and private physicians (probably).
Negatives: Specific limitations of each statute.
Administrative exhaustion: ?
