What Health Care Reform Means to LGBTs

Health care reform was approved by the House Sunday, 219 to 212, providing more than 30 million Americans with access to coverage. But for LGBT Americans, crucial health care provisions will be excluded.

The bill prevents health care providers from denying Americans coverage because of preexisting conditions and expands coverage to nearly 95% of Americans. But the bill does not include LGBT-specific provisions, such as data inclusion, that were included when the House bill first passed last November.

Rep. Tammy Baldwin of Wisconsinsaid that while the bill isn't perfect, it keeps the legislative door open to pass LGBT health care provisions in the future.

"We will have many opportunities to deal with this legislation's imperfections," she said. "We don't vote on health care reform of this magnitude very often, but we regularly deal with all sorts of bills that relate to different programs in health. I hope to be able to advance the provisions that we lost with other bills."

Baldwin linked the loss of LGBT provisions to the special election in Massachusetts that swept Republican Scott Brown into the late senator Ted Kennedy's seat. The loss of the Senate supermajority forced the House to take up the Senate-passed bill, which did not contain concrete language regarding gay and lesbian health.

"Elections matter," Baldwin said. "Elections have consequences. Now we find ourselves with the House adopting the Senate-passed bill."

The only provision in the current legislation of special interest to LGBT people deals with costs accrued by AIDS Drug Assistance Programs. The measure prevents Medicare patients with HIV or AIDS who receive prescription medication assistance from being subject to other prescription drug costs.

This provision differs from The Early Treatment for HIV Act in the original health care bill, which would have provided Medicaid to low-income HIV-positive people. This measure, along with data inclusion, are not included in the final bill.

Data inclusion would provide information to doctors and researchers about gay health, information that currently isn't collected by federal health studies. It is unknown whether gay men have higher risks of heart disease of if lesbians are more susceptible to breast cancer. Of the data known about gay and lesbians, only limited statistics on depression, HIV rates and smoking are available.

M.V. Lee Badgett, research director of the Williams Institute for Sexual Orientation Law and Public Policy at the University of California, Los Angeles, School of Law, said in a January interview with The Advocate that LGBT data inclusion is not only essential for medical research but also makes for better public policy.

"We can't know if there are problems [for gay people] accessing health care systems unless we have data to make those comparisons," Badgett said. "We would be able to see if there are differences. We need data to understand why those differences exist."