President Barack Obama's signature domestic issue, health care reform, was passed by the House of Representatives last Sunday and promptly signed by the president on Tuesday. And while we are deeply disappointed that several measures that would have leveled the playing field for LGBTs were dropped from consideration, millions of Americans will be able to obtain health insurance under this new law. Parts of the law don't go into effect until 2014, but some provisions do kick in immediately.
According to the White House's Web site, starting this year children with pre-existing conditions can no longer be denied health insurance coverage. And once the new health insurance exchanges begin in the coming years, pre-existing condition discrimination will become a thing of the past for everyone.
This year, health care plans will allow young people to remain on their parents' insurance policy up until their 26th birthday.
This year, insurance companies will be banned from dropping coverage when people get sick and from implementing lifetime caps on coverage. This year, restrictive annual limits on coverage will be banned for certain plans. Under health insurance reform, Americans will be ensured access to the care they need.
This year, adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary subsidized high-risk pool.
Significantly, there are real, tangible benefits for PWAs. Advocates at Project Inform note that the bill:
- Helps low-income people with HIV by expanding Medicaid eligibility to include all low-income people up to 133 percent of the federal poverty level, thus allowing people with HIV to qualify for Medicaid before they become sick. This will cover an additional 16 million low-income Americans.
- Provides help to those on Medicare. People who fall into the coverage gap (people with HIV generally fall into the coverage gap in the second to third month of the year) will get some immediate help; eventually the coverage gap will be filled in.
- Will eventually reduce the burden on Ryan White-funded programs, which depend on yearly funding battles.
- Will allow AIDS Drug Assistance Program dollars to count toward the amount of money a person on Medicare needs to move through the coverage gap and get meaningful coverage; will provide savings to ADAP and allow people to get access to all the drugs they need under Medicare.
- Requires insurance plans to contract with Ryan White providers (who have expertise in HIV care).
We call on Congress to revisit the LGBT-related provisions that were dropped from the legislation this time around and to include them in future changes to the bill. Of the four, three are critical: providing early treatment of HIV infection; prohibiting discrimination based on sexual orientation or gender identity; and ending the tax on gay employees for health coverage they provide through their employers to their partners or spouses. This last item is the most egregious since it amounts to an unfair tax that straight people do not have to pay.
On to ENDA
Now that the 14-month debate over health care reform is winding down (although we know that it won't stop and that Republicans will continue their opposition), it's time for Congress to move ahead and pass the Employment Non-Discrimination Act. Congresswoman Tammy Baldwin (D-Wisconsin) continues to insist that the votes are there (in the House) and that Speaker Nancy Pelosi is committed to moving the bill to the floor for a vote. Baldwin and Representative Barney Frank (D-Massachusetts) have both told reporters in recent days "Now, it's our turn," and they're right. ENDA has been shuffled around Congress since the early 1990s. This is a bill that will help with job protections for LGBTs, and in this economy, every job that is saved is important.
ENDA does not yet have 60 votes in the Senate, and that is a problem that must be solved. We're not sure that last week's direct action by the new group Get Equal was strategically timed, as Congress and much of the media was consumed with the health care developments, nevertheless, activists drew some attention to themselves in both DC and San Francisco. In DC they pushed for repeal of the military's anti-gay "Don't Ask, Don't Tell," in San Francisco they advocated passage of ENDA.
Now, however, the harder work of constituents contacting lawmakers must begin, especially in the Senate. When California state Senator Roy Ashburn (R-Bakersfield) came out as gay earlier this month, he said that his voting record was anti-gay because that's what his constituents wanted. We know that there are LGBTs and same-sex couples in Ashburn's district. We'll see in coming months if they reach out to Ashburn to tell him that his vote is needed on a variety of LGBT-related legislation in Sacramento.
At the national level, it is much the same. Legislators need to hear from their constituents, the people they represent. LGBTs and straight allies must make those phone calls. They are the single most effective way of persuading a lawmaker on an issue. In fact, Frank said that ENDA picked up a Republican co-sponsor recently because the representative received a visit from gay constituents.
One can only chain themselves to the White House fence so many times before it becomes just another publicity stunt. In this case, direct action needs to evolve from pickets to picking up the phone or scheduling a visit to your lawmaker's district office.