On April 26, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) released a final rule interpreting section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability. The rule—which drew more than 85,000 comments—reinstates many Obama-era nondiscrimination regulations that were modified or eliminated by the Trump administration in 2020 and continue to be litigated. Implications of the rule for state policymakers are explained below.

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