2) A Stay of Proceedings Need Not Terminate at a Date Certain

statutes, it creates a separate right. If those provisions as written and interpreted were sufficient to protect against discrimination in health care to the extent the ACA demanded, then Sec.1557 would not have been required. The ACA changed what was acceptable in health care and significantly changed the obligations of covered entities, therefore the pre-ACA case law and limitations should not be dispositive

Despite clear legislative intent from the breadth and scope of the ACA and the inclusion of Sec. 1557 as a key enforcement mechanism in addition to existing mechanisms, courts have frequently looked to Sec. 504 case law and interpretation to inform the interpretation of Sec. 1557. This includes limiting claims of discriminatory benefit design and other claims of discrimination. For example, several cases have applied the principles of analyzing disparate impact disability discrimination in insurance benefits under Sec. 504 as prescribed in Alexander v. Choate to Sec. 1557 claims. Doing so should not only be improper because it fails to recognize Sec. 1557 within the larger reform of the ACA, but also because many of these Sec. 1557 decisions have applied an overly narrow read of these Sec. 504 standards to Sec. 1557 claims.

While we do not argue that Sec. 1557 requires covered entities to provide limitless benefits, the ACA set new standards for what insurers could and could not do, what essential health coverage looked like, and that people must have access to coverage at affordable prices regardless of their conditions. For example, Congress directed that the health care needs of diverse segments of the population be considered and that

3 Plans may still use an array of methods to limit coverage, but must do so in a nondiscriminatory fashion.4 The ACA requires not just access to coverage, but sets requirements for the content of that coverage.

Importantly, pre-ACA cases, like Choate and Sandoval, were decided in a different world and conception of coverage. Choate e context of coverage at that time, which the ACA has dramatically changed. Subsequent courts have misinterpreted Choate to not reach the

infiltrated Sec. 1557 enforcement. Such interpretations are improper even under Sec. 504 because Choate

policy disproportionately prevented people with disabilities from receiving a meaningful benefit from the inpatient coverage. In addition, a framing of discrimination in health insurance as only a matter of access would allow an insurer to manipulate their benefit design to elude discrimination law, despite discriminatory effects. The impact of such decisions on insurers can be seen in some of the practices for which the ACA corrected.

3 42 U.S.C. § 18022(b)(4). 4 See, e.g., id. §§ 300gg-6, 18022(c).