Thursday, Aug. 20, 2009
A Look at Healthcare Reform
Health insurance coverage? Preventative care? Delivery system reform? I’m not sure about you, but I’m feeling a little overwhelmed with all this talk about healthcare reform. In watching the news, listening to Obama answer questions at town hall meetings and reading the bombardment of mixed messages you can find online – I still have one important question – what does it mean to me?
What does healthcare reform mean to LGBT families?
Will it change how LGBT people are treated in hospitals and doctor’s offices across the country? Will it open up benefits to same-sex couples and their families?
The National Coalition for LGBT Health has been looking at these exact issues as well and recently released a document titled “Guiding Principles for Lesbian, Gay, Bisexual and Transgender Inclusion in Healthcare Reform.” These principles have been sent to President Obama and members of Congress for consideration. According to Rebecca Fox, national director of the organization, “LGBT people suffer disproportionately from the adverse health effects of stigma, stress and violence, further compounded by the barriers that prevent them from accessing vital healthcare services even for routine care.”
The Department of Health and Human Services recognized these barriers in the ’90s during its 10-year plan for improving the nation’s health, Healthy People 2010, and again in Healthy People 2020, in which the HHS Secretary’s Advisory Committee called on the necessity of targeting the specific needs of the LGBT community when undertaking healthcare system reform. Yet, you hear nothing of it on the nightly news and very rarely in LGBT news outlets.
Here’s a quick look at some of the issues that the National Coalition for LGBT Health looks at in its report:
• A Guaranteed Access to Care. The current system of employer-based coverage is often a barrier to people in the LGBT community, when many companies do not extend coverage eligibility to same-sex partners and children that may be a part of those families. Even when companies do provide domestic partner benefits, federal tax law still creates extra barriers to both the individual and the employer. Currently 57 percent of Fortune 500 companies, as well as 16 state governments and the District of Columbia offer these benefits. However, health benefits offered to (heterosexual married) spouses and children are tax-exempt, but those same benefits are taxed when offered to domestic partners and same-sex spouses in the states where those marriages are recognized. A joint study by CAP and The Williams Institute found that these taxes add up to $1,069 per year for the average employee receiving benefits and $57 million annually for the employers that offer them. This discourages many companies from offering an equitable policy for domestic partner families. The House Ways and Means Committee’s version of the health reform bill contains language from the Tax Equity for Health Plan Beneficiaries Act, which should end this differential tax treatment for health benefits to domestic partners.
• Inclusion of LGBT Identities and Families in Policy and Legislation. This is more of a technical issue that adversely affects coverage to LGBT families. The organization calls for a removal of terms like “family,” “parent” and “spouse,” which are often used to exclude LGBT families on the basis that they are not protected by legal marriage in many states. Only six states currently recognize same-sex marriages and only nine states specifically allow an LGBT person to adopt their partners’ children. According to the report, “as long as the federal government’s definition of families is exclusive of LGBT households, same-sex partners who have entered into domestic partnerships and civil unions will not be able to access healthcare through programs designed to cover families, such as the State Children’s Health Insurance Program.”
• Transgender issues. Whenever you talk about healthcare and the LGBT community, you cannot overlook the plethora of problems that exist for transgender people. The high rate of discrimination toward transgender people in the workplace often results in higher rates of unemployment and further reduces access to coverage. Many transgender individuals with a previous diagnosis or history of treatment for transsexualism report being denied basic coverage from insurance providers. Many insurance plans, private and public, also do not cover the costs of transitioning (or sex-change surgery and hormone treatments). Transgender people also have very specific health needs. “They may require medical treatment related to both their birth-assigned gender and their current gender,” according to Josh Rosenthal with the Center for American Progress. In a report on LGBT issues in health reform, Rosenthal points out an example of a transgender woman who may be at risk for both prostate cancer and breast cancer.
• Confidentiality. While providers should be open to their clients, so that patients feel comfortable to discuss their sexual orientation and/or gender identity, thus improving the care provided – they must also follow strict guidelines of confidentiality in medical reports. It is still legal in 30 states to fire someone on the basis of sexual orientation, and 38 states allow an employer to fire someone on the basis of gender identity. Health information technology can improve care and save costs, but it could also put LGBT people at risk.
Healthcare reform is much needed in our country. It will help LGBT people as much as it will all Americans, when finally resolved. However it is still essential, as it is in other communities like the African-American and Latin-American communities, that LGBT-specific issues be taken into consideration and looked at to ensure a package that helps instead of hinders our community as a whole.
These are just some of the issues that should be addressed in looking at an inclusive healthcare reform and not add to discrimination. To view the entire report by the National Coalition for LGBT Health visit www.lgbthealth.net.
Out & About
Saturday, Aug. 22 – Red Ribbon Friends is hosting a Red, White and Blue Party at midnight on Saturday at Time Out!, 520 Eighth Ave. N. in downtown Myrtle Beach. The event will feature local entertainment and will benefit Careteam’s 2009 5K Run and AIDS Walk, which takes place Nov. 7. Red Ribbon Friends is a volunteer organization formed to offer assistance and support for people in the LGBT community whose lives have been touched by HIV and AIDS. For more information visit www.redribbonfriends.com.
Till next week, have fun and be safe.
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