Obamacare: The LGBT Factor

What does this election mean for health care reform?
by Camille Beredjick

When President Barack Obama signed the Affordable Care Act in 2010, he acknowledged how the law would affect health care for LGBT Americans, including protection against discrimination and greater access to preventive care. Gov. Mitt Romney staunchly opposes the colloquially named “Obamacare,” claiming the law raised taxes and added a trillion dollars in health care spending, and he has vowed to repeal it. But what does that mean for LGBT people?

Joseph Jefferson, senior policy associate at the National Coalition for LGBT Health in Washington, D.C., helps lead efforts to secure LGBT-inclusive policies via the Affordable Care Act. He’s now working with the Coalition to build advocacy efforts on national and local levels. Jefferson, 50, answered questions in an email interview about what the Affordable Care Act means for LGBT people and what voters need to know. Excerpts:

MEDILL EQUAL MEDIA PROJECT: THE AFFORDABLE CARE ACT ADDRESSES SEVERAL ASPECTS OF LGBT HEALTH. WHICH ARE THE MOST SIGNIFICANT?
Joseph Jefferson: The ACA provides a range of benefits for all Americans, including LGBT people. Among the most significant:

1) The ACA will extend insurance coverage to many previously uninsured LGBT people via the expansion of Medicaid, as well as the new health insurance Exchanges (for individuals and families whose incomes are between 133 and 400 percent of the FPL [federal poverty level]).

2) Beginning in 2014, insurance companies will no longer be allowed to deny coverage to people with a pre-existing condition like HIV/AIDS.

3) The ACA’s Patient’s Bill of Rights, which went into effect in 2010, prohibits annual and lifetime caps on coverage. This is of tremendous importance for people with chronic diseases, like HIV/AIDS.

4) The ACA prioritizes new programs, research and data collection that focus on marginalized populations, like LGBT [people].

5) The ACA ensures that a range of preventive services, like breast cancer screenings, will now be offered without any co-pay requirements.

HAVE ANY OF THESE POLICIES ALREADY BEEN IMPLEMENTED?
[The third and fifth policies] have gone into effect. The bulk of the ACA provisions go into effect in 2014 and 2015. While we expect that increased access to care, more investments in developing evidence-based programming, and higher rates of coverage will lead to significantly improved health outcomes among LGBT people, it will be a few years before we can quantify these gains.

HOW WILL THIS ELECTION AFFECT HIV/AIDS CARE AND RESEARCH?
HIV/AIDS has not been the subject of debate in this election. However, Gov. Romney has promoted in general terms across-the-board reductions in non-defense discretionary spending. We can assume that HIV/AIDS-related care, treatment, and research budgets would be reduced by anywhere between 8 to 20 percent.

SHOULD HE WIN, HOW WOULD GOV. ROMNEY’S HEALTHCARE POLICIES AFFECT LGBT AMERICANS?
Gov. Romney’s position is that the ACA should be repealed. If the ACA is indeed repealed, the many provisions that are intended to increase access and coverage would, presumably, be eliminated.

REGARDLESS OF WHO WINS THE ELECTION, WHAT STEPS SHOULD LGBT AMERICANS TAKE TO PROTECT THEIR HEALTH AND ACCESS TO HEALTH CARE?
First, LGBT people must be out to their providers and ensure that their provider is sufficiently equipped to offer culturally appropriate services. Beyond that, LGBT folks need to be informed about what’s happening in their states as the ACA is being fully implemented. They can access thistoolkit for more information.

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© 2012 Medill Equal Media Project
Medill School of Journalism | Northwestern University
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