Health Equality: Our New Opportunity

Helping our community improve its health is our new opportunity for LGBT equality, and the Affordable Care Act (a.k.a. "Obamacare") provides a great foundation upon which to build that equality.
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Last week was LGBT Health Awareness Week, the one week set aside each year to stress the importance of LGBT health. Coincidentally, most of our community was awash in a sea of red and pink equal signs on Facebook to show their solidarity for marriage equality. Given the historic nature of the arguments, this was all well, good, and necessary, but raises the question for all of us: Where do we stand when it comes to our health equality?

Helping our community improve its health is our new opportunity for LGBT equality, and the Affordable Care Act (a.k.a. "Obamacare") provides a great foundation upon which to build that equality. As Joe Biden said at its signing, the ACA is a "big f*#&ing deal." And while we're on our way to full legal equality, what good will it be if we aren't healthy enough to enjoy it? Or as openly-gay writer Augusten Burroughs more eloquently stated, "When you have your health, you have everything. When you do not have your health, nothing else matters at all."

You remember the Affordable Care Act, right? It was the legislation passed in 2010 after years of legal and political wrangling to offer wider health care options and coverage for all Americans. Part of the ACA provides for new insurance options in all 50 states.

The real bottom line, though, is that beginning next year everyone will be required to buy health insurance. Just like we have to buy car insurance for our vehicles, we will all have to buy health insurance for our bodies. And sure, it might sound like an intimidating task. After all, not many people chat casually, or delightfully, about health insurance.

A survey from Enroll America found that more than 75 percent of uninsured Americans are not aware of their health care options, and more than 80 percent are unaware that they may even qualify for Medicaid. While we don't know how many of those polled were LGBT, we do know from earlier surveys that the LGBT community is more likely than non-LGBT individuals to be uninsured.

Even the current Secretary of Health and Human Services, Kathleen Sebelius, knows that LGBT health needs are unique and has addressed it publicly by raising awareness and illustrating what the Administration is doing to improve our health, including rolling out the Affordable Care Act.

This may be the first time many people in the LGBT community have access to insurance, and the community especially needs to know all the options and what questions to ask. Fortunately, the process of researching and buying health insurance will be easier than you think. Here are three things to keep in mind:

1. Regardless of where you live, you will have access to subsidized insurance products. In some states, Governors have gladly offered to implement the ACA by operating online health insurance exchanges, basically marketplaces. In other states, governors have flatly refused to participate. But, you're not out of luck. In each of those states, you will still have access to a health insurance exchange through one run by the federal government. If you are a U.S. citizen or legal immigrant and don't have insurance from your employer, you will be able to sign up for insurance through an exchange beginning in October of 2013.

2. You may qualify for help to pay for health insurance. To make insurance products more affordable, tax credits will be available to low to moderate income individuals and families, as well as certain small businesses. Individuals making between $15,000 and $43,000 each year can receive subsidies on a sliding scale, meaning the less you make, the more your tax credit will be. The law also limits the out of pocket expenses for lower income individuals. Because of the Defense of Marriage Act, however, same sex couples are treated as individuals under this law.

3. Health insurance exchanges cannot discriminate. Tucked into the ACA is a provision that prohibits discrimination based on both sexual orientation and gender identity by the exchanges in any of their activities. It also prohibits discrimination based on sexual orientation and gender identity by the health plans offering insurance in state exchanges. Additionally, starting in 2014, a pre-existing condition cannot be used by health insurers to deny insurance coverage. This will be critically important for individuals living with HIV/AIDS.

This is just the start of the conversation. For now, don't let that deadline for buying health insurance creep up on you without learning as much as possible about your options. Don't just do this for yourself. Do it for those who love you and support you, and for those you love who have gone without health insurance for so long.

This is a "big f*#&ing deal." It's your health. Without it, what kind of equal lives will we ever get to lead?

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