The U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) has issued its final rule implementing Section 1557 of the Affordable Care Act prohibiting discrimination on the basis of race, color, national origin, sex, age, and disability. Discrimination based on sex includes discrimination based on pregnancy, gender identity, and sex stereotyping. Discrimination based on national origin includes discrimination based on limited English proficiency.

While the final rule does not resolve whether discrimination on the basis of an individual’s sexual orientation status alone is a form of sex discrimination under Section 1557, the rule makes clear that OCR will evaluate complaints that allege sex discrimination related to an individual’s sexual orientation to determine if they involve the sorts of stereotyping that can be addressed under 1557. HHS supports prohibiting sexual orientation discrimination as a matter of policy and will continue to monitor legal developments on this issue.

The final rule also states that where application of any requirement of the rule would violate applicable federal statutes protecting religious freedom and conscience, that application will not be required.

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