The U.S. Department of Health and Human Services (HHS) proposed a rule on Thursday that would update provisions in Section 504 of the Rehabilitation Act of 1973 and effectively bolster disability protections that were outlined in the federal law 50 years ago.
Section 504 of the Rehabilitation Act of 1973 is a landmark civil rights law that prohibits disability discrimination in any program or activity that receives federal funding or that is conducted by a federal agency, such as public secondary or elementary schools, hospitals and nursing homes.
The regulation, Section 504, was championed by disability advocates, which led to its implementation four years after the law was signed, and served as a foundation for the Americans With Disabilities Act of 1990 (ADA).
HHS’s new proposed rule ― which would be the first alteration made to Section 504 since 1977 ― would update and clarify obligations to provide nondiscriminatory health care and social services to disabled people, which are not explicitly stated in the current version of Section 504.
The rule, for instance, would establish an enforceable standard for accessible medical equipment, which would eliminate a barrier faced by more than 20 million disabled adults who have a disability that impacts their mobility, according to the National Council on Disability (NCD). Additionally, it would include a section to clarify requirements in child welfare services.
Language would also be included in the amendment to ensure “medical treatment decisions are not based on biases or stereotypes about individuals with disabilities, judgments that an individual will be a burden on others, or beliefs that the life of an individual with a disability has less value than the life of a person without a disability.”
According to an HHS document outlining the proposed rule, the amendment would ensure that Section 504 is interpreted in a way that is consistent with other disability laws such as the ADA, the ADA Amendments Act of 2008, and the Affordable Care Act, along with the multiple statutory amendments that have been added to the Rehabilitation Act.
“It is crucial that section 504 be interpreted consistently with these developments and laws to ensure conformity with current law and to protect against discrimination on the basis of disability,” HHS Secretary Xavier Becerra wrote in the document.
HHS said in its statement on Thursday that the current version of Section 504 will remain enforced while it undertakes the rulemaking.
Disabled People Continue To Face Discrimination In Federally Funded Programs And Settings
Despite federal protections, disabled Americans continue to face discrimination in health care and social service programs.
“The COVID-19 pandemic shone a spotlight on the discrimination that too many people with disabilities continue to face, from denial of medical treatment due to ableism, to inaccessible medical equipment and websites, to having no choice but to receive services in institutional settings,” Alison Barkoff, who is a part of the Administration for Community Living, said in a statement on Thursday.
In 2020, disabled people were denied care in Oregon hospitals on the grounds that they had a “lower quality of life,” NPR reported. States across the country were also rationing plans that allowed for the discrimination of disabled and elderly people in the event of a crisis — such as the pandemic — as a means of dealing with medical care shortages.
The use of “low quality of life” as justification for denying care was also reflected in 2022, when children with Down Syndrome and other intellectual disabilities in various states were being denied organ transplants, CBS News reported.
According to a 2021 report by the NCD, the Access Board found in 2013 that access barriers such as inaccessible medical equipment was among the reasons that disabled people were susceptible to experiencing inadequate health care.
The board issued a final rule establishing technical criteria for medical diagnostic equipment in 2017, but statutes implementing regulations in federal disability laws do not currently require health care providers to have such accessible equipment at their facilities.