This week’s passage of historic health care legislation will improve the lives of millions of Americans, including many people in the lesbian, gay, bisexual, and transgender community. To quote President Obama, “This isn’t radical reform, but it is major reform,” and while LGBT anti-discrimination provisions were not included in the final bill (pdf), the passage of health care reform is a momentous achievement that will save lives and will improve access to much-needed health care. Once reform is fully implemented, more than 95 percent of the country will have health insurance coverage, including 32 million who are currently uninsured. This matters to LGBT people because:
1. A disproportionate number of LGBT people are poor (pdf) and/or homeless due to pervasive discrimination. Extending health care coverage to an additional 32 million economically disadvantaged people will help a critically vulnerable segment of our community gain access to basic medical care.
2. Under the new law, adult children under the age of 27 will be allowed to stay on their families’ insurance policies, even after they leave home and/or graduate from college. Between 1 million and 9 million children are being raised by LGBT parents in the United States today and poverty rates for children of same-sex couples are twice as high as poverty rates (pdf) for children of different-sex married couples.
3. According to the Williams Institute , studies show that people in same-sex couples are more likely to be uninsured than are people in married different-sex couples. A 2006 survey of national data showed that 20 percent of people in same-sex couples were uninsured, compared with only 11.5 percent of married individuals.
4. A study analyzing the National Health Interview Survey found that women in same-sex couples were statistically significantly less likely to have health insurance than women in different-sex relationships.
5. Women will no longer be subjected to “gender rating,” a practice used by insurance companies to charge women more than men for the exact same policies—and under reform, maternity care will be covered.
6. Community health centers would receive an additional $11 billion (pdf), doubling the number of patients who can be treated regardless of their insurance or ability to pay.
7. Health insurance companies will no longer be allowed (pdf) to deny people coverage because of preexisting conditions. This provision will be a tremendous benefit to transgender people, people with HIV, and people with cancer, including the disproportionate number of lesbians who suffer with breast cancer.
Given how many lives and personal economies have been ruined due to unaffordable health care, this legislation will prevent disaster for millions of people. But we recognize that this bill comes at a cost. There is no coverage of undocumented immigrants, which is shameful. There are restrictions on reproductive freedom, which are outrageous and must be remedied. And the failure to include specific anti-discrimination protections for LGBT people is unconscionable. The final package also did not include a provision which would have eliminated the tax paid on domestic partner health benefits offered by employers.
LGBT individuals are entitled to health care free of prejudice and we must continue our work to eradicate barriers faced by LGBT people in accessing health care. We must advocate for a woman’s right to choose, a physician’s right to provide the care that he or she believes is medically appropriate and necessary to his or her patients without unwarranted interference from the government, and full and equal access to health care for all people, including equal access to assisted reproduction. NCLR is working with other civil rights organizations to protect and advance these precious human rights.
While this legislation is imperfect—a product of compromise—it is a foundation upon which to build. And while there is much work to be done, including adding anti-discrimination provisions for LGBT people, this unquestionably is a historic moment. President Obama just signed one of the most significant progressive laws passed in decades. This is a tremendous, hard won victory, and we must continue our work to fill the gaps left by this bill.
There is much to be learned by the long journey to passing this legislation, which teetered on the brink of defeat on several occasions. Our nation remains deeply polarized, with opponents of health care reform resorting to familiar fear-mongering and hate-filled tactics. Members of Congress who supported health care reform were targeted in appalling ways, and Tea Party activists hurled racist and anti-gay epithets at African American and openly gay Representatives. Our community is all too familiar with these opponents, the very same who support anti-LGBT ballot measures. However, this week we rose to victory and trampled their campaign of scare tactics and lies. That victory reverberates across the nation, and we must sustain this momentum, stay true to our vision, and not fall prey to divisiveness.
In the coming weeks, we will be put to the test again. Already, the debate over the reconciliation bill rages on in the Senate. We will see similar debates as President Obama pushes for comprehensive immigration reform and as our community fights for long overdue workplace protections and the repeal of Don’t Ask, Don’t Tell.
We are in historic times and we are witnesses to and participants in groundbreaking, but still flawed, victories. We all need to engage, get active, be involved, and sacrifice like never before to make certain that the changes we seek and the gains we make include our community. This has to be our time.