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The National Women’s Law Center (NWLC) Files Administrative Complaints HHS Alleging Sex Discrimination in Plan Coverage

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June 2013

The NWLC filed five administrative complaints with the United States Health and Human Services Department’s Office for Civil Rights against a health care system and several higher education institutions (public and private) alleging the institutions violated ACA Section 1557 by excluding coverage for pregnancy and related medical care for dependents other than a participant’s spouse from their health insurance benefits. Section 1557 of the Affordable Care Act protects individuals from discrimination on the basis of sex, race, color, national origin, age, disability, gender identity, and sex stereotypes under any health program or activity, any part of which is receiving Federal financial assistance, including credits, subsidies, or contracts of insurance, or under any program or activity that is administered by an Executive Agency. The provision was aimed at health insurers selling plans for which consumers can obtain federal subsidies starting with the 2014 plan year, but the NWLC contends the provision also applies to universities and other employers already receiving federal funds. If the advocacy efforts of the NWLC in favor of mandatory pregnancy coverage for dependents other than the participant’s spouse are successful, employers who are recipients of federal grants may be required to provide such coverage under the health plans they sponsor. 

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