In June, the Department of Health and Human Services (HHS) proposed a rule change that seeks to vastly change the health care landscape of the nation. On Tuesday (August 21), the American Medical Association (AMA) offered a pointed rebuke to the plan.

The ironically named “Nondiscrimination in Health and Health Education Programs or Activities” rule seeks to revise Section 1557 of the Patient Protection and Affordable Care Act, which makes discrimination on the basis of “race, color, national origin, sex, age or disability” illegal for people who participate in:

  • Any health program or activity any part of which received funding from HHS
  • Any health program or activity that HHS itself administers
  • Health Insurance Marketplaces and all plans offered by issuers that participate in those Marketplaces

The AMA came out strong against the rule change via a statement that began: “The AMA is strongly criticizing a proposed Department of Health and Human Services rule that would do away with Affordable Care Act (ACA) protections for LGBTQ people, women, immigrants, minorities and other patients.”

It’s a public-facing statement that backs up a letter submitted during the 60-day commenting period on the rule, which ended on August 13. “This proposal marks the rare occasion in which a federal agency seeks to remove civil rights protections,” AMA executive vice president and CEO James L. Madara wrote to HHS Secretary Alex Azar II. “It legitimizes unequal treatment of patients by not only providers, health care organizations and insurers, but also by the government itself—and it will harm patients. Such policy should not be permitted by the U.S. government, let alone proposed by it.”

Per the Henry J. Kaiser Family Foundation, if the rule goes into effect, it will have the following impact:

  • Eliminating the general prohibition on discrimination based on gender identity, as well as specific health insurance coverage protections for transgender individuals;
  • Adopting blanket abortion and religious freedom exemptions for health care providers;
  • Eliminating the provision preventing health insurers from varying benefits in ways that discriminate against certain groups, such as people with HIV or LGBTQ people;
  • Weakening protections that provide access to interpretation and translation services for individuals with limited English proficiency;
  • Eliminating provisions affirming the right of private individuals to challenge alleged violations of § 1557 in court and to obtain money damages, as well as requirements for covered entities to provide non-discrimination notices and grievance procedures;
  • Narrowing the reach of the regulations by only covering specific activities that receive federal funding, but not other operations, of health insurers that are not “principally engaged in the business of providing health care,” and no longer applying the regulations to all HHS-administered programs.

Now, HHS will consider public’s comments and decide how to proceed. But the AMA says the decision is clear, and encourages HHS officials to “redirect their efforts toward advancing health care access and equity for all.”