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Health Discrimination Fight Could Change Your Website

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What You Need to Know

  • AHIP says member insurers mail out an average of about 34 million paper language services notices per year.
  • Language services provisions are part of new draft health care and health insurance antidiscrimination regulations.
  • Another part relates to gender dysphoria.
  • Out2Enroll says that, in 2021, 46% of plans studied covered at least some gender dysphoria care.

Federal health regulators could soon create a universal language access symbol.

America’s Health Insurance Plans (AHIP), a group for health insurers, has argued that website users who have trouble with English need such a symbol to give them an easy-to-spot way to reach interpreter services, translated documents and other support services.

AHIP has asked the U.S. Department of Health and Human Services to develop, test and pilot use of the universal language access symbol. Because the symbol HHS developed would be the product of federal government work, it likely be free from copyright or trademark restriction.

What It Means

You may already have a stop sign in front of your house, and a magnifying glass icon on your website search form.

In a few years, your website could use a universal language access icon to show visitors where to click to get help in Spanish, Chinese or even sign language.

The Draft Regulations

Jeanette Thornton, an AHIP executive vice president, made the plea for a universal language access symbol in a letter commenting on the U.S. Department of Health and Human Services’ new draft nondiscrimination regulations.

HHS developed the draft regulations to reverse efforts by the administration of former President Donald Trump to narrow the scope of antidiscrimination regulations developed by the administration of another former president, Barack Obama.

The original regulations implemented Section 1557 of the Patient Protection and Affordable Care Act. PPACA is part of the two-act Affordable Care Act statutory package.

The Obama-era regulations applied Section 1557 to discrimination based on sexual orientation and gender identity and provided detailed instructions on how health care providers and health plans should serve people with limited ability to use English.

The Trump administration officials eliminated the provisions relating to gender identity and sexual orientation, arguing that those provisions exceeded the authority granted by the statute, and they replaced the detailed language support requirements with a requirement that a regulated entity “take reasonable steps to ensure meaningful access to its programs.”‘

The Tagline Problem

HHS now requires insurers to put tagline information for consumers about language services on websites and to include paper tagline notices with many letters sent to consumers.

The average AHIP member sends out about 34 million paper tagline notices per year, at a cost of as much as $8.91 per member per month, without seeing any evidence that the taglines are increasing members’ use of language services, according to AHIP survey data.

“Adoption of a language access symbol may provide easier-to-access translation services at a lower administrative cost,” Thornton says.

The Discrimination Provisions

Thornton says AHIP members oppose discrimination and inequality in any form.

“AHIP strongly supports federal law protections that prohibit discrimination based on race, color, national origin, sex, gender identity, sexual orientation, age or disability,” she says.

AHIP supports having those provisions taking effect 60 days after the final version of the regulations is published, she adds.

Out2Enroll, a group that supports strong benefits for gender dysphoria, reported in its own comment on the draft regulations that, in 2021, only 7% of the mid-level plans available through the Affordable Care Act public exchange system included exclusions for transgender care.

The percentage of plans saying they will cover some or all medically necessary treatment for gender dysphoria increased to 46% in 2021, from 18% in 2017, the group says.

But Out2Enroll notes that a few insurers have added transgender-specific benefits exclusions since 2017.

Information Barrier

When Out2Enroll analysts tried to analyze plans’ gender care benefits, they came up against a problem that could face agents and advisors trying to help clients with a wide range of health insurance issues: lack of ability to get detailed plan documents.

About 13% of the insurers studied failed to provide certificates of coverage, the group says.

(Image: Adobe Stock)


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