This Pride Month, LGBT health advocates are celebrating the ACA

This post is a guest blog from our partners at Raising Women's Voices for the Health Care We Need.

“The Affordable Care Act may represent the strongest foundation we have ever created to begin closing LGBT health disparities.” That’s how U.S. Secretary of Health and Human Services Kathleen Sebelius described the impact of the new health care law on lesbian, gay, bisexual and transgender people.

To help the LGBT community learn how the Affordable Care Act (ACA) is moving us in that direction, and recognize what is at stake in the Supreme Court’s decision on the ACA, Raising Women’s Voices for the Health Care We Need has created a new fact sheet: How the Affordable Care Act helps LGBT people get the care we need.

For example, the ACA is already helping LGBT people by eliminating lifetime limits on the amount of medical expenses covered by health plans, even if we have high medical bills from a condition such as HIV or cancer, and by requiring insurers to cover important preventive health services without co-pays. We have even more benefits and protections to look forward in 2013 and 2014:

• -- Starting in 2013, national data collection efforts will begin to include sexual orientation and gender identity questions to help researchers and policymakers better understand LGBT health disparities.
• -- In January 2014, each state will have a Health Benefit Exchange, a health insurance “supermarket” where individuals and families can buy quality health care plans at an affordable price. Under rules HHS Secretary Sebelius issued recently, no state’s Exchange may discriminate against consumers on the basis of sexual orientation, gender identity, or other factors such as race, ethnicity, primary language or disability. This non-discrimination policy is a significant victory for LGBT people.

To help realize the promise of the ACA for the lesbian, gay, bisexual and transgender community, Raising Women’s Voices has led the creation of a new LGBT Task Force within Health Care for All New York, the state’s health reform coalition.  I outlined the goals of the new task force at its first meeting, held in New York City on May 21:

• -- Bring a sharp analytical focus to the issues that concern LGBT people as New York’s newly-established health Exchange is developed
• -- Inform and mobilize LGBT people about what is at stake for us and our families
• -- Bring more LGBT groups into the Health Care for All New York (HCFANY) coalition as it works for influence state Exchange policies and procedures.

The Task Force is already moving forward to staff a booth at the NYC Pride Fest on June 24 and to conduct “listening sessions” with LGBT people about their health care concerns.

Joining members of the new task force for its initial meeting was Andrew Cray, a policy analyst at the Center for American Progress in Washington, D.C. Cray and Kellan Baker are leading the center’s LGBT State Exchanges Project, which is working with advocates in five states where health Exchanges have been formally established: California, Colorado, Maryland, Nevada and Oregon.

Cray outlined some of the issues LGBT people face in obtaining and using health coverage, compared to the general population: lower rates of insured, obstructed access to health care services, lack of cultural competency in health care delivery and lack of data collection on LGBT people’s health problems. Higher-than-average rates of breast cancer, depression and HIV/AIDS are among the health disparities experiences by LGBT people.

The LGBT Health Exchanges Project is encouraging advocates to focus on three areas of state health Exchange development:

• -- Equal access: Regulations issued by the U.S. Department of Health and Human Services prohibit state Exchanges and their contractors from discriminating against anyone based on sexual orientation or gender identity. In practice, this nondiscrimination policy should mean equal access to affordable coverage for same-sex families and transgender people. One example of an advocacy focus is ensuring that the “benchmark” insurance plan chosen as a model for plans to be offered in a state Exchange is inclusive, not exclusive, in its coverage of services relevant to LGBT people.
• -- Consumer engagement: It is important that state insurance Exchanges conduct outreach to LGBT people in a culturally-competent manner and choose LGBT community organizations to serve as Exchange-funded “Navigators” to help their constituents enroll in plans offered by the Exchange.
• -- Data collection: To better serve LGBT people, state Exchanges need to encourage voluntary self-identification of applicants’ sexual orientation and gender identity. This can be accomplished by explaining how data collection can improve plan offerings for LGBT people and by ensuring there are robust confidentiality protections.

-- Lois Uttley, co-founder of Raising Women’s Voices for the Health Care We Need and convenor of the new LGBT Task Force within Health Care for All NY