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Recently, the U.S. Department of Health and Human Services (HHS) issued a final rule on changes to be made to section 1557 of the Affordable Care Act. Many such changes are shocking and disappointing; however, I’d like to focus on one specific change as it relates to my work with COVID-19 Health Literacy Project. Previously, entities covered in the Affordable Care Act were required to issue a nondiscrimination notice in the top 15 non-English languages used where the entity operates. The notice would provide instructions of how an individual could file discrimination complaints, as well as explanations of available nondiscrimination assistance services. After the recent rule, these entities are no longer explicitly required to issue this nondiscrimination information in non-English languages.

How ironic, I thought, that a ruling about a nondiscrimination issuance could be so discriminatory. The usual targets of discrimination across the U.S. and the communities that would be in need of translation services have immense overlap. Thus, this new rule serves to strip many targeted communities of their empowerment to take action against discrimination. At a time when we have been observing devastating disparities in COVID-19 outcomes based on socioeconomic factors, this step backwards is troubling.

The COVID-19 Health Literacy Project has been working towards increasing access to health information for non-native English speakers by creating COVID-19 fact sheets translated into 37+languages. Individuals from all over the world have contributed to the work of translating and vetting these materials. Moreover, entities across the globe have been widely distributing these fact sheets in an effort to reach as many non-native English speakers as possible. Thus, when I read about the recent rule of the HHS, I have to question the apparent disconnect. I’d like to think that it is governing bodies whose values are not fully aligned with those of healthcare workers on the ground. I do worry, though, that the volume of healthcare entities that do not prioritize their non-native English speakers’ needs is much greater than I previously perceived.

I am grateful for the experience to work with COVID-19 Health Literacy Project, because it has highlighted practices that I’d like to upkeep in my future career as a physician. Healthcare workers should continually strive to meet the needs of diverse patient populations – regardless of if federal policy explicitly tells us to do so. I’d prefer federal policy provide accountability measures, and I hope to see this rule change in the future. For now, I am rendered optimistic by the self-motivation and initiative I’ve witnessed within the healthcare community these past few months.


Read about the new rule here: