Heather Skrabak
90 Geo. Wash. L. Rev. 1291
When Congress passed the Affordable Care Act in 2010, Section 1557 of the legislation promised powerful nondiscrimination protections in healthcare on the bases of race, color, national origin, sex, age, and disability. This was a thrilling new development, as Congress had already extended civil rights protections against discrimination to other areas, such as education, housing, workplaces, voting, and government services. However, in the years since the legislation’s passage, regulations have struggled to clarify how such extensive protections should apply in the specific context of healthcare. Regulations from multiple administrations have faced litigation, particularly regarding their application to the healthcare of transgender individuals.
Previous judicial statutory interpretations have failed to fully capture the proper healthcare context of the statute. This Essay argues that nuances of healthcare should be used to clarify statutory interpretation in three areas: (1) the scope of Section 1557, (2) Section 1557’s definition of “sex discrimination,” and (3) provision of additional religious freedom exemptions. A properly contextualized interpretation of Section 1557 considers healthcare’s universality, personal nature, and emergency potential. This Essay will demonstrate that, in light of the Supreme Court’s decision in Bostock v. Clayton County, the Obama administration’s 2016 application of the statutory text to the healthcare context was correct.
