To mark the second anniversary of the federal health care reform law, The National Gay and Lesbian Task Force and the Center for American Progress held a webinar at the end of March, “Learn Your Power: How the Affordable Care Act Helps LGBT Americans.” These organizations were joined by the Department of Health and Human Services and One Colorado, Colorado’s statewide LGBT equality organization, to address the health care issues faced by LGBT people and their families.
The goal of the online gathering was to outline changes brought about by the Affordable Care Act and educate LGBT people on how they can maximize the benefits of the law, which protects all Americans from the worst insurance company abuses.
“The LGBT community faces specific challenges in both the workplace and in the hospital. Providers are not equipped with the cultural competency they should have to adequately serve the needs of the LGBT community,” said Mayra Alvarez, director of Public Health Policy, Office of Health Reform, Department of Health and Human Services. “Studies show health disparities related to sexual orientation and gender identity are due, in part, to lower rates of health care coverage and this lack of cultural competency.”
The new law, according to Alvarez, pays specific attention to the unique health care needs of LGBT people. “It builds on what works and fixes what’s broken. We have a lot of work to do and encourage feedback from the community,” said Alvarez, who noted the changes to their website where the health coverage finder now includes a same-sex partner filter. “For the first time in our countries history, regardless of your sexual orientation or gender identity, you’ll be able to get affordable health care coverage.”
Health disparities, discrimination
“LGBT people and their families are among those affected by our broken and imbalanced health care system,” said Darlene Nipper, deputy executive director of the National Gay and Lesbian Task Force. “Studies show that LGBT people often face higher incidences of health disparities and greater discrimination in health care settings than the public at large.”
Findings from reports such as Injustice at Every Turn: A Report of the National Transgender Discrimination Survey http://transequality.org/PDFs/Executive_Summary.pdf, show that 50 percent of transgender respondents indicated they have to teach their medical providers about transgender care. Nineteen percent of transgender people reported being refused medical care outright due to their transgender or gender non-conforming status.
“Unfortunately, we found even higher numbers among people of color in the survey,” said Nipper, adding that factors such as race, ethnicity, socioeconomic status, geographic location and age further exacerbate these disparities. The health care reform law, according to Nipper, has a greater impact on LGBT people because of disproportionate unemployment, uninsurance and because LGBT people have more pre-existing conditions than many other Americans, a critical public health issue in this country.
“These observations remind us that LGBT people aren’t just defined by sexual orientation and gender identity, but have multiple identities that shape who they are,” said Nipper. “This law ensures that LGBT people have access to the health care they need and literally (the law) has the potential to save the lives of LGBT people. But not enough people know about the benefits.”
Prior to March 2010 when President Obama signed the Affordable Care Act into law, fifty million Americans were uninsured. Tens of millions more were underinsured, and those that had coverage were often afraid of losing it.
HHS Secretary Kathleen Sebelius said in a fall 2011 speech to the National Coalition of LGBT Health that the Affordable Care Act may represent the strongest foundation our nation has ever created to begin closing LGBT health disparities. Sebelius said “We’ve come along way, but we still have a long way to go.”
The report, Changing the Game: What Health Care Reform Means for Gay, Lesbian, Bisexual and Transgender Americans http://www.americanprogress.org/issues/2011/03/pdf/aca_lgbt.pdf, released by the Center for American Progress discusses more in-depth how the law will help LGBT people by 2014.
The law is key to efforts such as expanding cultural competency in the health care workforce to include LGBT issues, making preventative care available to everyone who needs it, improving data collection to better identify and address health disparities, and recognizing the increasing diversity of America’s families. LGBT people in communities around the country will have the opportunity to participate in the Community Transformation Grants program and other wellness and prevention initiatives supported by the $15 billion Prevention and Public Health Fund.
“Various efforts are being made on the federal side to ensure the implementation of the act includes LGBT people,” said Kellen Baker, senior policy associate at the National Coalition for LGBT
Health and one of the report’s authors. “The law has great potential to help the LGBT community and is already doing so from the perspective of national advocacy. We all look forward to seeing the programs role out later this spring.”
As the conclusion to the report states: “Before comprehensive health care reform became the law of the land, too many lesbian, gay, bisexual and transgender people were destined to remain uninsured and unable to afford regular checkups and basic medical care. Too many in the LGBT community faced the prospect of continuing to go to bed at night worrying about paying their health care bills, and too many gay and transgender parents envisioned a future where they would continue to be unable to afford to take their children to the doctor. Passage of the Affordable Care Act changed all of that.
Implementation of the Affordable Care Act is a historic opportunity for transforming our health system, prioritizing prevention and wellness, and making health care affordable and accessible for everyone. In order for the aspirations of the law to be fully realized, however, the federal government and the states must explicitly ensure that gay and transgender Americans and their families are fully covered under the new law. The LGBT community and its allies must take action to move successful implementation forward and to defend the law from efforts to defund or otherwise dismantle it.”