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Fighting for Survival

Fighting for Survival

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Kellan Baker explains why the gay and transgender community should care about the pending Supreme Court ruling on the Affordable Care Act.
Kellan Baker explains why the gay and transgender community should care about the pending Supreme Court ruling on the Affordable Care Act.

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Published by: Center for American Progress on Jun 21, 2012
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02/01/2013

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1Center or American Progress | Fighting or Survival
Fighting for Survival
Why Gay and Transgender CommunitiesShould Care About Health Reform
By Kellan Baker June 21, 2012
Introduction
Imagine sanding nex o a hospial bed, waching someone gh or his or her lie.No one would ever wan o be in ha posiion. And mouning doubs darken hepicure even urher: Is he paien receiving he bes care possible? Are he hospial’sdocors and nurses sreched oo hin o cach an emergency beore i happens? Doeshe paien have enough insurance coverage o pay or an expensive say in he hospi-al, and who picks up he ab i no?Te Aordable Care Ac is helping us answer hese quesions. Among oher prioriies,he law calls on healh care providers, aciliies, and insurers o ocus on improving hequaliy o care every paien receives. I emphasizes he imporance o srenghening hehealh care workorce, and i esablishes new proecions in he healh insurance markeha make insurance more aordable and comprehensive.Bu no sep orward comes wihou a gh, and he Supreme Cour is expeced odecide he 26-sae lawsui agains he Aordable Care Ac during he las week o June.
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 Te lawsui atemps o challenge commonsense provisions o reorm such as he expan-sion o he Medicaid program o cover lower-income people wihou insurance and herequiremen ha each individual secure a minimum level o healh insurance coverageo pay or he coss o he medical care each o us may need a some poin in our lives.Similar o he millions o ohers in America who are alling hrough he cracks o heprereorm healh sysem, gay 
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and ransgender people should care abou he oucome— because hey have a lo o lose wihou healh reorm. According o Deparmen o Healh and Human Services Secreary Kahleen Sebelius,“LGB Americans ace numerous barriers o healh—rom providers who jus don’undersand heir unique healh needs, o diculy geting healh insurance because
 
2Center or American Progress | Fighting or Survival
hey can’ ge coverage hrough a parner or a spouse. And unorunaely way oo many LGB individuals ace discriminaion and bigory in he healh care sysem.Forunaely, she noes, “he Aordable Care Ac may represen he sronges oundaion we have ever creaed o begin closing LGB healh dispariies.
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Below are some o helaw’s numerous benes or gay and ransgender individuals and communiies.
Data collection to better understand gay and transgender health disparities
 According o he law, he secreary o Healh and Human Services may collec any demographic daa he or she believes o be imporan or undersanding and addressinghealh dispariies. In June 2011 Secreary Sebelius announced a plan or including sexualorienaion and gender ideniy in naional daa collecion eors saring in 2013, inaddiion o he laws required caegories o race, ehniciy, primary language, sex, anddisabiliy saus.
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Te sae-based healh insurance exchanges, which will sell aordableprivae healh insurance coverage saring in 2014, also oer an opporuniy o gaherdaa on he insurance needs and experiences o gay and ransgender enrollees.
Patient’s Bill of Rights to end health insurance industry abuses
Te new Paien’s Bill o Righs oulaws many o he insurance indusry’s wors abuses.I ended lieime limis on coverage in 2010 and will phase ou annual limis on cover-age by 2014, boh o which are paricularly imporan or people wih high medical billsrom condiions such as HIV or cancer. As o 2014 i also prohibis insurance carriersrom denying coverage on he basis o a pre-exising condiion such as HIV or a rans-gender medical hisory and rom arbirarily canceling a sick person’s coverage.
Expansion of public insurance coverage through Medicaid
Te law ses a new naional hreshold or Medicaid eligibiliy. Saring in 2014 adulsunder age 65 who make less han $15,000 per year will be eligible or Medicaid coveragein every sae. Tese 16 million newly eligible Medicaid beneciaries will include many gay and ransgender Americans and heir amilies, since widespread discriminaion inhe workplace and in relaionship recogniion means gay and ransgender people aredisproporionaely likely o have lower incomes and o be uninsured.
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In paricular, he expansion will bene hose living in he 10 saes wih he mosresricive curren Medicaid eligibiliy sandards, including exas, Alabama, Arkansas, Virginia, and Louisiana. Tese 10 saes are home o an esimaed 1.5 million gay and
 
3Center or American Progress | Fighting or Survival
ransgender Americans, many o whom are lower-income Arican American and Lainalesbian couples raising children.
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Expansion of private insurance coverage through the exchanges
Te law also requires every sae o operae a healh insurance exchange saring in2014. Te exchanges will oer subsidies ha allow small employers and individuals whomake beween $15,000 and $43,000 per year o purchase aordable privae coverage.Exchanges may no discriminae on he basis o sexual orienaion or gender ideniy inany o heir aciviies, and all exchange plans mus oer comprehensive benes across10 essenial healh bene caegories, including prescripion drugs, hospial says, andmenal and behavioral healh services.
Coverage of preventive care
Under he Aordable Care Ac, all Medicare beneciaries receive ree annual check-ups, and insurance companies may no charge co-pays or oher ees or preveniveservices ha are recommended by he U.S. Prevenive Services ask Force.
7
Teseservices include HIV and oher sexually ransmited inecion esing, depressionscreening, vaccinaions, obacco-use screening, choleserol and high-blood-pressurescreening, and oher services o paricular imporance or gay and ransgender people.Te Women’s Healh Amendmen also requires insurers o cover comprehensiveprevenive services or women, including conracepion, inimae-parner violencescreening, and annual well-woman visis.
Easy-to-find information about health reform for consumers
Te websie www.healhcare.gov—one o he consumer-riendly reorms he law requires—is he one-sop shop he Deparmen o Healh and Human Services main-ains or all hings relaed o healh reorm. Te sie oers a wide range o inormaionabou he law, including a Healh Plan Finder ool ha allows consumers shopping orcoverage o compare plan deails such as cos-sharing and bene design in order ochoose he opion ha bes mees heir needs.Same-sex couples, many o whom do no have access o healh insurance hrough heirown or heir parner’s employer, can use a buil-in ler o nd plans oering coverageor domesic parners. Te exchanges may also oer relevan inormaion o gay andransgender consumers hrough oureach and enrollmen mechanisms such as websies,phone services, and navigaor programs.

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