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States Sue Over Trump Administration ACA Discrimination Changes

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New York Attorney General Letitia James is leading an effort by 23 states to oppose new federal Affordable Care Act (ACA) discrimination regulations.

The administration of President Donald Trump recently adopted the new regulations to repeal antidiscrimination regulations adopted during the administration of former President Barack Obama.

The Obama administration adopted the original regulations in an effort to implement Section 1557 of the Patient Protection and Affordable Care Act (PPACA).

The original regulations included detailed provisions intended to protect the rights of people with disabilities, people with limited ability to speak and understand English, and people who are lesbian, gay, bisexual or transgender (LGBT).


  • A copy of the complaint filed by Letitia James and other attorneys general is available here.
  • An earlier article about states’ responses to the discrimination regulation change is available here.

PPACA is one of the two statutes included in the Affordable Care Act.

Trump administration officials have argued that, although many of the goals of the Obama administration regulations were admirable, the Obama administration officials went beyond the statutory authority provided by PPACA.

In addition to James, the list of attorneys general opposing the Trump administration’s approach includes attorneys general from a number of other high-population states, including California, Pennsylvania, Illinois and North Carolina.

James’ coalition filed a complaint for declaratory and injunctive relief Monday in the U.S. District Court for the Southern District of New York.

The case is State of New York et al. v. U.S. Department of Health and Human Services et al. (Case Number 1:20-cv-5583).

“By rolling back rules that ensure the ACA protects all Americans, the president is unlawfully giving health care providers and insurers license to deny care to LGBTQ+ individuals, those who do not speak English, and women,” James said in a comment included in the lawsuit filing announcement. “It is never acceptable to deny health care to Americans who need it, but it is especially egregious to do so in the middle of a pandemic.

In the complaint, the states acknowledge that many of the states have state-level equivalents of the federal antidiscrimination rules that have been canceled.

But the states saying having their agencies investigate allegations of discrimination would be expensive.

In Illinois, for example, processing a discrimination charge in fiscal year 2019 was $4,695.65, according to the complaint.

In Minnesota, the plaintiffs say, the cost of investigating a typical state-level discrimination charge this year is about $2,200 to $3,000.

The plaintiffs also contend that confusion about the changes could cause some people to avoid getting needed care for COVID-19, and that people’s reluctance to get needed care could hurt efforts to reduce the spread of the virus that causes the disease.

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