Americans United for Life has submitted a Comment in support of the U.S. Department of Health and Human Services’ (HHS) proposed rule revising Section 1557 of the Affordable Care Act (ACA) to better enforce civil rights in healthcare and comply with the mandates of Congress. 

Section 1557 is the ACA’s civil rights provision that prohibits discrimination in certain health programs or activities on the basis of race, color, national origin, sex, age, or disability. Under this Section, Congress prohibits discrimination by referencing existing federal civil rights laws, including Title IX of the Education Amendments of 1972. Despite Title IX’s longstanding definition of “sex” as biological sex, HHS under the Obama Administration issued regulations in 2016 redefining discrimination “on the basis of sex” to include “termination of pregnancy” (and “gender identity”) and ignored Title IX’s religious and abortion exemptions. The proposed rule returns sex discrimination to its original meaning and explicitly adopts the exemptions in Title IX. 

Under the proposed rule, HHS would continue to vigorously enforce civil rights in healthcare, but add explicit regulatory language that Section 1557 shall be enforced consistent with the ACA’s healthcare conscience protections (Sections 1303 and 1553, concerning abortion and legalized suicide, respectively) and existing constitutional provisions and federal laws that protect religious freedom and conscience rights, such as the First Amendment to the Constitution, the Religious Freedom Restoration Act, the Church Amendments, the Coats-Snowe Amendment, the Weldon Amendment, the Hyde Amendment, and the Helms Amendment. 

AUL wrote in support of the proposed rule’s clarification that sex discrimination does not include “termination of pregnancy,” the explicit inclusion of Title IX’s religious and abortion exemptions, and the identification and incorporation of federal religious freedom, conscience, and nondiscrimination laws.