The Affordable Care Act transformed healthcare for millions of Americans through some well-known ways, such as ending discrimination against people with pre-existing conditions. However, for the 20 percent of Americans with disabilities, the ACA is transformative in improving their access to healthcare in more ways than one. According to Section 1557 of the ACA, healthcare providers are required to ensure that “all health programs and activities provided through electronic and information technology [are] accessible.”
For many of us, this rule may not seem that significant. However, we have entered a new age in which information technology is playing a significantly larger role in our interactions with health providers. Online portals allow us to access our medical records easily, access billing statements, communicate with healthcare providers, and set up appointments with just a click of a button. The health insurance marketplaces set up by the ACA allow us to compare insurance plans and prices online, from the comfort of our home.
However, millions of Americans, including those who are blind or low vision, individuals with cognitive disabilities, or those with mobility impairments, often don’t have equal access to online information, something that Section 1557 is looking to fix in the healthcare sphere. Those who have mobility impairments or vision-related disabilities may rely on screen reader technology to read out the contents of a webpage that they would like to navigate. If this webpage is not optimized with features such as skip navigation, alternative text for images, and labels for links, it becomes significantly harder for them to be able to navigate through the page. For individuals with cognitive disabilities, page timeouts, complex language, and poor contrast between text and backgrounds can make it more difficult for them to be able to use the web page.
As of July 18, 2016, health care providers who receive federal financial assistance were required to comply with Section 1557, although the Department of Health and Human Services did not not note specific standards to which the providers would have to comply. Additionally, managed care programs were required to comply with “modern accessibility standards,” which include Section 508 of the Rehabilitation Act and the Web Content Accessibility Guidelines (WCAG) 2.0, which is often considered the standard for information technology accessibility.
If the ACA is repealed, it is likely that we would lose these improved regulations, and we would not see further clarifying guidance released on how Section 1557 should be interpreted by healthcare providers. By rolling back these accessibility requirements, millions of patients with disabilities would have to simply hope that their healthcare provider complies with common accessibility standards so that they can have equal access to online patient systems and health information. There are millions of websites online that do not comply to WCAG 2.0 guidelines, either because website developers are not aware of the guidelines or do not consider accessibility a priority. Leaving it up to the developer and the provider to “do the right thing” without prompting to make their information technology accessible will result in many websites remaining inaccessible to patients with disabilities.