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The Affordable Care Act and Nondiscrimination: What Every Hospital Should Know

The Affordable Care Act and Nondiscrimination:  Section 1557 – Ensuring Access to Limited English Proficient Applicants


Healthcare marketplaces, insurers, and contractors who work under the auspices of the Affordable Care Act (ACA) are obligated to provide language services for Limited English Proficient (LEP) applicants.  At this year’s National Council on Interpreting in Health Care membership meeting, Mara Youdelman, Managing Attorney at the National Health Law Program (NHeLP), presented information about the ACA’s nondiscrimination provision, Section 1557.

Section 1557 extends the civil rights provisions of “Title VI, Title IX, Section 504 of the Rehabilitation Act, and the Age Discrimination Act” (as cited by Youdelman[i]), which had been applied to the marketplaces themselves, to “any health program or activity, any part of which is receiving Federal financial assistance, including credits, subsidies, or contracts of insurance, or under any program or activity that is administered by an Executive Agency or any entity established under this title.”[ii]  This establishes that any state or federal marketplace, any insurance plans working with the marketplaces, and any contractor (call center, outreach program, etc.) working with the marketplaces must also provide services to meet the needs of LEP applicants.

The Office of Civil Rights has just put out a Request for Information as a next step in finalizing the ACA regulations.  Depending on how these regulations are written, there may be additional implications related to language access.  As such, it becomes even more important for all involved with the ACA to understand what comprises adequate language service provision and ensure services are in place and properly used as soon as possible.

For more information, please see Mara Youdelman’s 2011 write-up at:

For more information about federal requirements related to language access see:

For the information on the Office of Civil Rights Request for Information, go to:

[i] Youdelman, Mara.  The Application of the ACA § 1557 and Title VI of the Civil Rights Act of 1964

to the Health Insurance Exchanges.  National Health Law Program.  January 2011.

[ii] Ibid.

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