What is Section 1557 and Why Should You Care
When most people think about the Affordable Care Act, also known as the ACA, they believe it only provided alternative pathways to healthcare, and it did, but that is only part of the story. The landmark healthcare shift paved the way to address systemic inequalities within the American Healthcare System.
Signed in 2010 by executive order, The ACA included a policy known as Section 1557. This policy became the first federal provision that protected patients from discriminatory practices and eliminated the use of biased clinical decision making tools (think evaluations, diagnostics tools, lab tests, etc). It also mandated healthcare institutions to prove they were working to prevent and rectify inequalities in their own practices.
Two of the most prominent examples are the formation of Independence Blue Cross’s, also known as IBX, Regional Coalition to Eliminate Race Based Medicine. This coalition, made up of Philadelphia based health groups and physicians across medical disciplines, are working to remove racial labels from 15 commonly used clinical decision making tools, making IBX the first insurance company to throw their hat in the ring to fight racial discrimination in medicine.
Similarly, UNOS, The United Network of Organ Sharing, and OPTN, The Organ Procurement and Transplant Network, mandated all Kidney Transplant Institutions reevaluated their Black patients with race neutral testing resulting in over 14,000 Black Americans gaining time on the kidney transplant list - the longest waiting list for an organ- and 3,000 transplants.
Though Section 1557’s finalization was paused during the first Trump presidency, The Department of Health & Services completed the process early 2024. The finalization included penalties for physicians and healthcare systems that violated section 1557’s regulations while giving patients a process to report violations.
With a second Trump Presidency quickly approaching, many analysts are questioning if Section 1557’s days are numbered. One of his main campaign promises included repealing the ACA and replacing it with “concepts of a plan”. If the ACA is repealed, not only will millions of Americans lose coverage but the only law holding healthcare professionals and institutions will be repealed as well.
Sources:
https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html
https://news.ibx.com/regional-coalition/
https://unos.org/news/waiting-time-adjustment-approved-for-kidney-transplant-candidates-affected-by-race-based-calculation/#:~:text=This%20has%20caused%20some%20Black,prohibited%20since%20July%2027%2C%202022.