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 sanding nex o a hospial bed, waching someone gh or his or her lie.No one would ever wan o be in ha posiion. And mouning doubs darken hepicure even urher: Is he paien receiving he bes care possible? Are he hospial’sdocors and nurses sreched oo hin o cach an emergency beore i happens? Doeshe paien have enough insurance coverage o pay or an expensive say in he hospi-al, and who picks up he ab i no?Te Aordable Care Ac is helping us answer hese quesions. Among oher prioriies,he law calls on healh care providers, aciliies, and insurers o ocus on improving hequaliy o care every paien receives. I emphasizes he imporance o srenghening hehealh care workorce, and i esablishes new proecions in he healh insurance markeha make insurance more aordable and comprehensive.Bu no sep orward comes wihou a gh, and he Supreme Cour is expeced odecide he 26-sae lawsui agains he Aordable Care Ac during he las week o June.
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Te lawsui atemps o challenge commonsense provisions o reorm such as he expan-sion o he Medicaid program o cover lower-income people wihou insurance and herequiremen ha each individual secure a minimum level o healh insurance coverageo pay or he coss o he medical care each o us may need a some poin in our lives.Similar o he millions o ohers in America who are alling hrough he cracks o heprereorm healh sysem, gay
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and ransgender people should care abou he oucome— because hey have a lo o lose wihou healh reorm. According o Deparmen o Healh and Human Services Secreary Kahleen Sebelius,“LGB Americans ace numerous barriers o healh—rom providers who jus don’undersand heir unique healh needs, o diculy geting healh insurance because
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hey can’ ge coverage hrough a parner or a spouse. And unorunaely way oo many LGB individuals ace discriminaion and bigory in he healh care sysem.”Forunaely, she noes, “he Aordable Care Ac may represen he sronges oundaion we have ever creaed o begin closing LGB healh dispariies.”
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Below are some o helaw’s numerous benes or gay and ransgender individuals and communiies.
Data collection to better understand gay and transgender health disparities
According o he law, he secreary o Healh and Human Services may collec any demographic daa he or she believes o be imporan or undersanding and addressinghealh dispariies. In June 2011 Secreary Sebelius announced a plan or including sexualorienaion and gender ideniy in naional daa collecion eors saring in 2013, inaddiion o he law’s required caegories o race, ehniciy, primary language, sex, anddisabiliy saus.
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Te sae-based healh insurance exchanges, which will sell aordableprivae healh insurance coverage saring in 2014, also oer an opporuniy o gaherdaa on he insurance needs and experiences o gay and ransgender enrollees.
Patient’s Bill of Rights to end health insurance industry abuses
Te new Paien’s Bill o Righs oulaws many o he insurance indusry’s wors abuses.I ended lieime limis on coverage in 2010 and will phase ou annual limis on cover-age by 2014, boh o which are paricularly imporan or people wih high medical billsrom condiions such as HIV or cancer. As o 2014 i also prohibis insurance carriersrom denying coverage on he basis o a pre-exising condiion such as HIV or a rans-gender medical hisory and rom arbirarily canceling a sick person’s coverage.
Expansion of public insurance coverage through Medicaid
Te law ses a new naional hreshold or Medicaid eligibiliy. Saring in 2014 adulsunder age 65 who make less han $15,000 per year will be eligible or Medicaid coveragein every sae. Tese 16 million newly eligible Medicaid beneciaries will include many gay and ransgender Americans and heir amilies, since widespread discriminaion inhe workplace and in relaionship recogniion means gay and ransgender people aredisproporionaely likely o have lower incomes and o be uninsured.
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In paricular, he expansion will bene hose living in he 10 saes wih he mosresricive curren Medicaid eligibiliy sandards, including exas, Alabama, Arkansas, Virginia, and Louisiana. Tese 10 saes are home o an esimaed 1.5 million gay and
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ransgender Americans, many o whom are lower-income Arican American and Lainalesbian couples raising children.
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Expansion of private insurance coverage through the exchanges
Te law also requires every sae o operae a healh insurance exchange saring in2014. Te exchanges will oer subsidies ha allow small employers and individuals whomake beween $15,000 and $43,000 per year o purchase aordable privae coverage.Exchanges may no discriminae on he basis o sexual orienaion or gender ideniy inany o heir aciviies, and all exchange plans mus oer comprehensive benes across10 essenial healh bene caegories, including prescripion drugs, hospial says, andmenal and behavioral healh services.
Coverage of preventive care
Under he Aordable Care Ac, all Medicare beneciaries receive ree annual check-ups, and insurance companies may no charge co-pays or oher ees or preveniveservices ha are recommended by he U.S. Prevenive Services ask Force.
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Teseservices include HIV and oher sexually ransmited inecion esing, depressionscreening, vaccinaions, obacco-use screening, choleserol and high-blood-pressurescreening, and oher services o paricular imporance or gay and ransgender people.Te Women’s Healh Amendmen also requires insurers o cover comprehensiveprevenive services or women, including conracepion, inimae-parner violencescreening, and annual well-woman visis.
Easy-to-find information about health reform for consumers
Te websie www.healhcare.gov—one o he consumer-riendly reorms he law requires—is he one-sop shop he Deparmen o Healh and Human Services main-ains or all hings relaed o healh reorm. Te sie oers a wide range o inormaionabou he law, including a Healh Plan Finder ool ha allows consumers shopping orcoverage o compare plan deails such as cos-sharing and bene design in order ochoose he opion ha bes mees heir needs.Same-sex couples, many o whom do no have access o healh insurance hrough heirown or heir parner’s employer, can use a buil-in ler o nd plans oering coverageor domesic parners. Te exchanges may also oer relevan inormaion o gay andransgender consumers hrough oureach and enrollmen mechanisms such as websies,phone services, and navigaor programs.
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Fighting for Survival
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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