NAACP

National Congress of the American Indians
National Council of Jewish Women
National Council of La Raza (NCLR)
National Health Law Program

National Partnership for Women & Families
National Women’s Law Center

ce: Ms. Georgiana Verdugo, Director Office of Civil Rights, HHS
Dr. Howard Koh, Assistant Secretary for Health, HHS
Dr. Garth Graham, Deputy Assistant Secretary for Minority Health, HHS


the interim final rule regarding grandfathered plans, grandfathered plans are exempt from
only those provisions contained in subtitles A and C of Title I, with the exceptions noted
within those subtitles and in the regulations. 75 Fed. Reg. 34559, 34563, 34567.
Although §1557 does state that it applies “except as otherwise provided for in” Title I,
nothing in §1251 conflicts with §1557. Thus, because §1557 is in subtitle G and there is
no conflict with §1251, §1557 applies to grandfathered plans.

Second, the Departments should clarify that changes made to a health plan in order to
comply with §1557 will not cause a grandfathered plan to lose its grandfathered status
unless such changes exceed the limits specified in the interim final rule. 75 Fed. Reg.
35444. As the explanation of the interim final regulations makes clear, if a health plan
alters its provisions in order to meet the requirements of federal or state law, including
the ACA, it will not lose its grandfathered status. However, as would be the case in
complying with other requirements of the law, if such changes exceed the limits of
changes set forth in paragraph (g)(1) of the interim regulations, the plan will lose its
grandfathered status. 75 Fed. Reg. 35444 (“Under these interim final regulations,
changes other than the changes described in 26 CFR 54.9815- 1251T(g)(1), 29 CFR
2590.7 15—1251(g)(1), and 45 CFR 147.140(g)(1) will not cause a plan or coverage to
cease to be a grandfathered health plan. Examples include changes to premiums, changes
to comply with Federal or State legal requirements, changes to voluntarily comply with
provisions of the Affordable Care Act, and changing third party administrators, provided
these changes are made without exceeding the standards established by paragraph (g)(1).”
(emphasis added))

Section 1557 will ensure that as our health care system reaches more Americans and
makes coverage more affordable, it does so in a manner free from discrimination based
on the grounds listed in §1557. Therefore, it is important that regulations implementing
the law, including the final regulations regarding grandfathering status, incorporate
§1557’s mandate and make covered plans, providers, and other programs aware of their
obligation to comply with the nondiscrimination protections of the law.

We look forward to working with you to ensure that the nondiscrimination provisions of
the ACA are fully integrated into the implementation of health care reform.

Sincerely,

AARP

American Association of People with Disabilities (AAPD)

American Civil Liberties Union

Asian & Pacific Islander American Health Forum

Black Women’s Health Imperative

Families USA

International Union, United Automobile, Aerospace & Agricultural Implement Workers
(UAW)

Japanese American Citizens League

Legal Momentum


Page | of 2

PEC-| \eyja-/0
'LEGAL PROCESSING DIVISION

PUBLICATION & REGULA
BRANCH TONS

As of: September 09, 2010

PUBLIC Status Posted

Posted: September 09, 2010
SUBMISSION Comments Due: August 16, 2010

Submission Type: Web

Docket: IRS-2010-0010
Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered
Health Plan Under the Patient Protection and Afforable Care Act

Comment On: IRS-2010-0010-0001
Group Health Plans and Health Insurance Coverage: Interim Final Rules for Relating to Status as
a Grandfathered Health Plan under the Patient Protection and Affordable Care Act

Document: IRS-2010-0010-0930
Comment on FR Doc # 2010-14488

Submitter Information

United States,

Organization: 16 members of the Leadership Conference for Civil and Human Rights’ Health
Care Task Force
ST

General Comment

Attached please find comments from 16 members of the Leadership Conference for Civil and
Human Rights' Health Care Task Force (listed below) re: File Code OCIIO-9991-IFC/RIN 1219-
AB42/REG-118412-10. Interim Final Rules for Group Health Plans and Heatth Insurance
Coverage Relating to Status as a Grandfathered Health Plan under the Patient Protection and
Affordable Care Act.

“

AARP;

American Association of People with Disabilities (AAPD);
American Civil Liberties Union;

Asian & Pacific Islander American Health Forum;

Black Women's Health Imperative;

Families USA;

International Union, United Automobile, Aerospace & Agricultural Implement Workers (UAW);
Japanese American Citizens League;

Legal Momentum;

NAACP;

National Congress of the American Indians;

National Council of Jewish Women;

National Council of La Raza (NCLR);

National Health Law Program;

National Partnership for Women & Families;

https://fdms.erulemaking.net/fdms-web-agency/component/submitterInfoCoverPage?Call=P... 9/9/2010


Page 2 of 2

National Women’s Law Center.

Attachments

IRS-2010-0010-0930.1: Comment on FR Doc # 2010-14488

https://fdms.erulemaking net/fdms-web-agency/component/submitterInfoCoverPage?Call=P... 9/9/2010


August 16, 2010

Office of Consumer Information and Insurance Oversight
Department of Health and Human Services

P.O. Box 8016

Baltimore, Maryland 21244-1850

Attention: OCIIO-9991-IFC

Office of Health Plan Standards and Compliance Assistance
Employee Benefits Security Administration

U.S. Department of Labor

200 Constitution Avenue NW

Washington, DC 20210

Attention: RIN1210-AB42

Internal Revenue Service

P.O. Box 7604 Ben Franklin Station
Washington, DC 20044

Attention: REG-118412-10

RE: File Code OCIIO-9991-IFC/RIN 1210-AB42/REG-118412-10. Interim Final
Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a
Grandfathered Health Plan under the Patient Protection and Affordable Care Act

Dear Sir or Madam:

Thank you for the opportunity to comment on the interim final regulations regarding the
grandfathering provisions of the Patient Protection and Affordable Care Act (ACA).
Many of the undersigned organizations have submitted comments on several aspects of
the interim final regulations; however, as members of the Leadership Conference for
Civil and Human Rights (the Leadership Conference) we collectively are submitting
these additional separate comments in order to stress the importance of §1557 of the
ACA,

Section 1557 of the ACA forbids discrimination on the grounds of sex, race, national
origin, disability or age in health programs or activities receiving federal financial
assistance or by programs administered by an Executive Agency or any entity established
under Title I of the ACA. Because §1557 applies broadly to federally conducted
programs and to entities that receive federal funding or assistance, it is essential that as
federal agencies issue regulations for the ACA, they consistently take the mandates of
§1557 into account and make clear how other ACA regulations interact with §1557. We
therefore recommend that the Departments clarify in these regulations the application of
§1557 to grandfathered plans.

First, we recommend that the Departments make clear that §1557 applies to
grandfathered plans. As stated in the ACA (§1251) and reiterated by the Departments in