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At NARAL Pro-Choice Maryland, we believe in the right to quality access to healthcare is essential to ensuring all childbearing individuals can decide for themselves if, when, and how to form their families. 

In May 2019, the Office of Civil Rights (OCR) and the Department of Health of Human Services (HHS) released a proposal to radically reinterpret and roll back protections for individuals seeking healthcare services under the Health Care Rights Law (Section 1557 of the Affordable Care Act).  These changes seek to discourage the use of language access plans to help providers determine how to best assist limited English proficient (LEP) individuals, eliminate notices of legal rights and in-language taglines (short statements at the top of relevant documents that inform people of their legal rights in their own language), and restrict the quantity and diversity of health insurance programs available to the population.  These alterations would disproportionately impact the most vulnerable sectors of the U.S. population—those with limited English proficiency (LEP), transgender populations, individuals with chronic illnesses, folks with disabilities, and women. For more information about the proposed changes, visit the National Health Law Program and Asian & Pacific Islander American Health Forum’s Fact Sheet

If you support access to quality healthcare for all, regardless of their English proficiency, gender identity, or medical status and want your voice to be heard, please submit a personalized comment to the U.S. Department of Health and Human Services and Office for Civil Rights.  You can find comment instructions and suggested language below.

Comment Instructions

We want as many letters of support for these protections as possible! But remember – the HHS notes that single, well-supported comments may carry more weight in the decision making process.  Please submit your comments by AUGUST 13th, 2019. 

To submit your comments, follow this link and drop your comments into the text box provided or attach your document.  For text box submissions, the character limit is 5000. Click the “Continue” tab on the bottom of the screen to review and submit your final comments.

Comment Template

For those who are interested in using a template to submit their comments, please consider using the following language in your submission:

Section Chief, Civil Rights Division and Supervisory Civil Rights Analyst Luben Montoya,

My name is [insert name here]. I am a [insert profession/credentials] in the state of Maryland, a state that has recognized the importance of high quality, affordable healthcare and the role it plays in the lives of the most vulnerable members of the population. Because I am a supporter of access to reproductive and sexual healthcare for all, I am deeply concerned about the changes proposed to the Health Care Rights Law and the impacts these rollbacks would have on access to reproductive and sexual healthcare in my state.

[Insert Your Thoughts Here]

The proposed changes to the Health Care Rights Law would remove requirements for all covered entities to post notices of legal rights in spaces where they are likely to be seen by individuals seeking healthcare coverage. The changes would eliminate requiring in-language taglines to be prominently featured on important insurance documents—taglines that notify individuals of their right to receive language assistance and to file a complaint if assistance is not received. Furthermore, the proposed changes discourage the development of language access plans and reduce the diversity of covered health programs. Each of these rollbacks would contribute to ending protections for individuals with limited English proficiency (LEP) and severely restrict their access to high quality, affordable healthcare. This is discrimination and I will not stand for it.

[Insert Your Thoughts Here]

An assault on protections for one group of individuals in this country is an assault on all of us. The ability to access healthcare—especially reproductive and sexual healthcare—is crucial to this country’s wellbeing. Without such access, the most vulnerable sectors of the population will suffer. Please consider the implications of these changes to the Health Care Rights Act and the impact they may have on those who are struggling the most. I hope you will reconsider these rollbacks and work towards making quality healthcare accessible to all.


[Insert Signature]

Additional Facts

(Source: National Health Law Program)

  • What is the Health Care Rights Law (HCRL)?
    • The HCRL is Section 1557 of the Affordable Care Act (ACA),  the nondiscrimination provision of the law.
    • It prohibits discrimination in health programs and activities receiving federal financial assistance, health programs and activities administered by the executive branch, as well as entities created under the ACA, including the Marketplaces and health plans sold through the Marketplaces.
    • Section 1557’s protections extend to discrimination on the basis of race, color, national origin (including language access), sex, age, and disability by referring to existing civil rights laws.
    • Section 1557 went into effect the day the ACA became law on March 23, 2010.
  • What kinds of programs and providers must comply with the HCRL/Section 1557?
    • Section 1557 applies to healthcare programs and activities receiving federal financial assistance or funding; programs administered by the federal government, including Medicaid and Medicare; and entities created under Title I of the ACA.
    • Covered entities include hospitals, clinics, and healthcare provider’s offices; and issuers selling health insurance plans within and outside of the ACA Marketplaces.
  • Why is the Trump/Pence administration revising the regulations for the HCRL/Section 1557?
    • The administration cites to a federal district court ruling in the Franciscan Alliance v. Azar case as its reason for revising the existing § 1557 regulations.
    • In Franciscan Alliance, a group of religiously affiliated health plans and several states challenged portions of the 2016 final rulemaking for section 1557, claiming that the Department of Health and Human Services (HHS) exceeded its authority when it defined sex discrimination to include gender identity and pregnancy status including termination of pregnancy.
    • Judge Reed O’Connor issued a nationwide injunction preventing HHS from enforcing those portions of the regulations as a preliminary matter.
    • However, the injunction does not prevent individuals from enforcing these provisions in other courts.
    • To date, the court has not yet issued a final ruling on the merits in Franciscan Alliance.
    • Thus, any changes the administration makes to the regulations implementing section 1557 are not pursuant to a court order.

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We fight for a future that includes access to all reproductive health care no matter your zip code or employer. Maryland must lead the charge. Are you with us?