How Obamacare Protects Same-Sex Families And Transgender Patients

Our guest blogger is Andrew Cray, health policy consultant for LGBT Progress.

Yesterday the Supreme Court issued its much-anticipated decision in the lawsuit challenging several key provisions of the Affordable Care Act. The justices’ ruling, upholding much of the law, will bridge the coverage gap for gay and transgender people through the creation of health insurance exchanges and the option for states to expand Medicaid program eligibility. But the decision doesn’t stop there — the justices also upheld all of the law’s key consumer protections, which will continue to serve as a lifeline for millions of Americans to receive the health care they need and deserve.

In particular, Court’s decision retains two key part of the law that were not front in center in the spotlight of the litigation, but that are of vital importance to the LGBT community: the extension of coverage to young adults, and the consumer protections incorporated in the Patients’ Bill of Rights.

Requiring that insurers offer coverage for young adults up to age 26 under their parents’ insurance makes it much easier for LGBT young adults to get access to necessary care. Through the requirement, the Affordable Care Act will continue to open up access to insurance for thousands of youth with gay and transgender parents, as well. In less than two years since this part of the law was implemented, over 80,000 young adults raised by LGBT parents have maintained access to insurance through their parents’ coverage — over one and a half times as many people as can fit into Yankee Stadium. That number will only grow after yesterday’s decision.

The second major victory following from the Court’s decision is the retention of the law’s Patient’s Bill of Rights. This provision creates new protections outlawing many of the insurance industry’s worst abuses by:

  • Ending lifetime limits on coverage, starting in 2010;
  • Phasing out annual limits on coverage by 2014, which is particularly important for people with long-term or chronic conditions such as HIV or cancer;
  • Starting in 2014, prohibiting insurance companies from denying coverage on the basis of a pre-existing condition, such as HIV or a transgender medical history;
  • Preventing insurers from arbitrarily canceling a sick person’s coverage, starting in 2014.

These essential protections will continue to ensure insurance access for many gay and transgender people by prohibiting insurers from unfairly targeting those who need access to care the most. For example, before the passage of the Affordable Care Act, one insurer denied a transgender woman coverage for routine treatments related to a cut on her hand and a deviated septum. When she appealed these coverage denials, she was told by the insurer that she was being denied coverage because of her “condition,” a reference to her gender identity. The laws’ prohibition on unfair and discriminatory insurance practices will prevent this type of abuse.

Recognizing the great importance of these protections for LGBT people, Secretary of the Department of Health and Human Services Kathleen Sebelius has stated, “the Affordable Care Act may represent the strongest foundation we have ever created to begin closing LGBT health disparities.” Having survived a trial by fire, we can look forward to a promising future with a revitalized health care system supporting healthier communities built on the foundation of healthcare reform.