The HHS Office for Civil Rights reflects on a year of advancing healthcare equity and civil rights through rule updates, enforcement actions, and community-focused initiatives under Melanie Fontes Rainer's leadership.
What happened
Melanie Fontes Rainer, Director of the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), released a statement reflecting the office's accomplishments under the Biden-Harris Administration. The OCR strengthened civil rights protections, enforced critical healthcare regulations, and implemented new rules to enhance accessibility and privacy in the health sector.
Going deeper
In the past year, the HHS saw transformative progress in key areas, from regulatory updates to community outreach. The OCR prioritized advancing civil rights and healthcare access by directly engaging with communities across the U.S. Since her appointment, Rainer and her team visited 30 states and one territory to address disparities and educate people about their rights.
Notable achievements include:
- Civil Rights protections: The HHS finalized updates to Section 504 of the Rehabilitation Act Rule, for the first in nearly 50 years, ensuring better accessibility for individuals with disabilities. Additionally, a new Section 1557 Rule under the Affordable Care Act reinforced protections against discrimination in health programs nationwide.
- Language access improvements: For the first time in a decade, HHS developed comprehensive language access plans across its divisions, enabling better communication for patients with limited English proficiency.
- HIPAA enforcement: The OCR resolved 22 cases under the HIPAA Privacy Rule’s Right of Access, collecting over $9.9 million in settlements and penalties, the second-highest in OCR’s history. This reinforced our commitment to empowering patients to access and control their health information.
- Addressing health inequities: OCR collaborated with the Department of Justice and local stakeholders in Lowndes County, Alabama, to address public health concerns caused by inadequate sanitation systems. Similar partnerships in Puerto Rico improved communication within the child welfare system, exemplifying its dedication to meeting community-specific needs.
Facing challenges head-on
In 2024, the HHS navigated significant challenges, including the fallout from the Supreme Court’s decision to overturn Roe v. Wade. After the decision was made, Rainer visited affected communities, including the last abortion clinic in St. Louis, Missouri, witnessing firsthand the impact on patients and providers. OCR responded by finalizing a rule to strengthen reproductive health care privacy under HIPAA, ensuring confidentiality and trust in patient-provider relationships.
The year also saw a rise in cyber threats to the healthcare sector. To address this, OCR issued a draft rule to enhance the HIPAA Security Rule, aiming to bolster cybersecurity measures across healthcare systems, a critical step in safeguarding patient information and national security.
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Community-centered advocacy
Throughout the year, Rainer and the HHS traveled to 30 states and one territory to engage directly with communities. Listening to patients’ and providers’ stories about barriers to care, stories of canceled appointments due to unavailable interpreters, inaccessible medical equipment, or discriminatory practices, these experiences informed the HHS’ priorities and policies, ensuring their work reflects the realities faced by people nationwide.
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What was said
Rainer emphasized the importance of civil rights in health care: “What good is a right, if you don’t know you have that right, you don’t understand your right, or that right is not being properly prioritized in your community?” Reflecting on challenges such as the overturning of Roe v. Wade, Rainer noted, “There, we saw in real time the impact of the loss of this important health care right as the clinic we were in scrambled to make changes and inform their patients.”
She also highlighted OCR’s proactive stance on cybersecurity, citing a recent draft rule aimed at improving healthcare system resilience against cyberattacks.
Why it matters
Access to health care is a fundamental right, but barriers such as language differences, disabilities, and systemic inequities continue to limit access for many. The OCR's initiatives under Rainer’s leadership have worked to dismantle these barriers, ensuring that all individuals—regardless of race, gender, or ability—receive equitable care. These efforts not only protect individual rights but also strengthen trust in the healthcare system.
FAQs
What is the role of the Office for Civil Rights (OCR)?
The OCR enforces civil rights laws, health information privacy, and security regulations to ensure equitable access to health care and human services for all individuals, free from discrimination.
Go deeper: What is the OCR and what does it do?
Why is enforcing civil rights in health care important?
Enforcing civil rights ensures all individuals, regardless of background, have access to essential health services, fostering equity and trust in the health care system.
Tshedimoso Makhene
