Section 1557: Ensuring Effective Communication with and Accessibility for Individuals with Disabilities

Section 1557 is the civil rights provision of the Affordable Care Act of 2010. Section 1557 prohibits discrimination on the ground of race, color, national origin, sex, age, or disability in certain health programs and activities. The Section 1557 final rule applies to any health program or activity, any part of which receives funding from the Department of Health and Human Services (HHS), such as hospitals that accept Medicare or doctors who receive Medicaid payments; the Health Insurance Marketplaces and issuers that participate in those Marketplaces; and any health program that HHS itself administers.

Protections for Individuals with Disabilities
  • Consistent with existing requirements, Section 1557 requires covered entities to take appropriate steps to ensure that communications with individuals with disabilities are as effective as communication with others. Section 1557 also requires covered entities to provide appropriate auxiliary aids and services, such as alternative formats and sign language interpreters, where necessary for effective communication.
  • Covered entities must post a notice of individuals’ rights, providing information about communication assistance among other information.
  • Covered entities are required to make all programs and activities provided through electronic and information technology accessible to individuals with disabilities, unless doing s o would impose undue financial or administrative burdens or would result in a fundamental alteration in the nature of the covered entity’s health program or activity.
  • Section 1557 incorporates the 2010 Americans with Disabilities Act Standards for Accessible Design as the standards for physical accessibility of new construction or alteration of buildings and facilities. Almost all covered entities are already required to comply with these standards.
  • Covered entities cannot use marketing practices or benefits designs that discriminate on the basis of disability.
  • Covered entities must make reasonable changes to policies, practices and procedures where necessary to provide equal access for individuals with disabilities unless the covered entity can demonstrate that making the changes would fundamentally alter the nature of the health program or activity.

For more information about Section 1557, visit

Content created by Office for Civil Rights (OCR)
Content last reviewed on August 25, 2016