HHS released a new proposed rule on Thursday to update nearly 50-year old regulations protecting people with disabilities from discrimination while seeking healthcare. Specifically, the 400-page proposal aims to update provisions included in Section 504 of the Rehabilitation Act, which was originally published in 1977. 

Section 504 prevents unfair treatment of individuals with disabilities when they are seeking care from healthcare programs that receive federal funding. With its new proposal, HHS is amending Section 504 to be clearer in its language, as well as more aligned with the Americans with Disabilities Act, the Americans with Disabilities Amendments Act and amendments to the Rehabilitation Act.

The proposed rule clarifies provisions within Section 504 by explicitly banning providers that receive federal funding from “denying or limiting medical treatment to a qualified individual with a disability when the denial is based on bias or stereotypes about a patient’s disability; judgments that an individual will be a burden on others due to their disability, including, but not limited to, caregivers, family, or society; or a belief that the life of a person with a disability has a lesser value than that of a person without a disability, or that life with a disability is not worth living.”

The proposed rule also elucidates obligations for web accessibility and bolsters nondiscriminatory provisions in the nation’s child welfare system, as well as creating enforceable standards for accessible medical equipment. For example, providers would be required to help transfer a patient from their wheelchair to the exam table or diagnostic chair without asking the person accompanying them for assistance.

Additionally, the proposal bans the use of value assessment methods that place a lower value on life extension services for people with disabilities. This is an important provision because patients with disabilities have been denied care in the past because their providers deemed them to have lower-quality lives, HHS wrote in its proposed rule.

The proposed rule points out that many Americans with disabilities still face medical discrimination despite the current regulations in place to protect them — and that recent research has proven this.

One of the studies referenced by HHS, published in 2021, found that many physicians believe that individuals with disabilities experience a lower quality of life, despite most people with disabilities reporting that they enjoy an excellent or good quality of life. The study also found that only 40% of physicians were confident about their ability to provide the same quality of care to patients with disabilities that they provide to patients without disabilities.

“It’s 2023, yet for many Americans, accessing basic health needs is still challenging. Some persons with disabilities may have to drive hours to get an accessible mammogram or receive the benefits and advancements of our healthcare system. This historic proposed rule will advance justice for people with disabilities and help ensure they are not subjected to discrimination under any program or activity receiving funding from HHS just because they have a disability,” HHS Secretary Xavier Becerra said in a statement.

The proposed rule is scheduled to be published in the Federal Register on September 14. After that, HHS will accept public comment on the proposal for 60 days.

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