Nondiscrimination Under the Affordable Care Act

Georgetown University Health Policy Institute, 2013

21 Pages Posted: 4 Dec 2013

See all articles by Katie Keith

Katie Keith

Georgetown University Health Policy Institute Center on Health Insurance Reforms

Kevin Lucia

Georgetown University Health Policy Institute Center on Health Insurance Reforms

Christine Monahan

Independent

Date Written: July 1, 2013

Abstract

The Affordable Care Act (ACA) includes expansive consumer protections on nondiscrimination. Prior to the ACA, federal and state law included some nondiscrimination protections, but most have had only a limited effect in ensuring that coverage meets the needs of all consumers. Through its broad incorporation of new standards, the ACA is designed to address this gap by prohibiting discrimination based on health status, disability, age, race, gender, and sexual orientation, among other factors. Yet, there are significant questions about how new nondiscrimination requirements are being implemented in practice. This report explores how stakeholders are grappling with these new protections as insurers design and market new products, regulators review and approve products, and consumers look to obtain coverage that best meets their needs.

Our findings suggest that new nondiscrimination standards have not significantly changed the way that state regulators or insurers approach benefit design and that regulators face practical limitations in trying to implement these requirements. Further, some regulators may not be willing to assume a much broader role in defining discriminatory benefit design without clearer federal standards. In light of such limitations, ensuring that the ACA’s nondiscrimination standards are met likely requires ongoing monitoring of consumer complaints, the development of new infrastructure such as tracking systems, robust grievance and appeals processes, and clarification of federal requirements.

Suggested Citation

Keith, Katie and Lucia, Kevin and Monahan, Christine, Nondiscrimination Under the Affordable Care Act (July 1, 2013). Georgetown University Health Policy Institute, 2013. Available at SSRN: https://ssrn.com/abstract=2362942

Katie Keith (Contact Author)

Georgetown University Health Policy Institute Center on Health Insurance Reforms ( email )

3600 N Street, NW Suite 200
Washington, DC 20057
United States

Kevin Lucia

Georgetown University Health Policy Institute Center on Health Insurance Reforms ( email )

3600 N Street, NW Suite 200
Washington, DC 20057
United States

Christine Monahan

Independent ( email )

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