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Healthcare reform garners tepid support from LGBT advocates

Social movements tend to occur in cycles. They are often characterized by troughs of slow and incremental change with an occasional accent of watershed reform along the way.

This past Tuesday’s historic presidential signing of a healthcare reform package that will extend coverage to over 32 million uninsured Americans is more likened to the latter, according to the Obama Administration. And while the passage of this measure has enjoyed positive billing by mainstream media as “the most expansive social legislation passed in decades” and the culmination of an effort first braved by President Theodore Roosevelt, LGBT advocates observe the new law as an important foundation for reform, but far from a panacea.

Let’s start with the undeniable benefits of the bill. The new law prohibits a popular practice by insurance companies known as “rescission” or dropping individuals from coverage upon diagnosis of a terminal illness or other sickness. Just days before passage of the bill, a rescission scheme by health insurance carrier Fortis - targeting HIV positive policyholders - was reported.

In late 2009, the South Carolina Supreme Court ruled that 17-year-old college freshman Jerome Mitchell’s coverage was wrongfully revoked upon knowledge of his HIV diagnosis. Court documents revealed that the company used a computer program which flagged all HIV positive policyholders for an automatic fraud investigation “as the company searched for any pretext to revoke their policy,” the Reuters story reported. Insurance companies will no longer be able to practice rescission with impunity.

Reforms also include immediate tax credits for small businesses that choose to offer health insurance for their employees, a ban on industry discrimination based on pre-existing conditions - a protection scheduled to go into effect this year for children and in 2014 for adults. In the interim, adults with pre-existing conditions will be placed in a “high-risk” insurance pool until the full ban is implemented.

Young adults can now remain on their parents’ insurance plans until they turn 26, and starting in 2014 all insurance plans must include preventative care. Cost containment measures, like the implementation of non-profit exchanges and government subsidies for low and moderate-income individuals and families, along with compulsory coverage or an individual mandate to obtain health insurance will go into effect in 2014. Employers with 50 employees or greater will also be required to offer policies to all employees, and seniors will experience enhanced Medicare coverage.

For LGBT advocates, however, the bill is a jagged pill - a necessary antidote for our ailing healthcare system, but difficult to swallow.

For years, national organizations like the Human Rights Campaign (HRC) and National Gay & Lesbian Task Force (NGLTF) fought to rid our employer-based healthcare system of an unfair tax levied on domestic partners when accessing healthcare benefits. They also lobbied hard for LGBT data collection by the Health & Human Services Agency, which would facilitate a better response by the federal government in addressing health disparities endemic to the LGBT community.

None of these provisions - once part of the initial healthcare package - appeared in the final bill. And there is no mention of them in the reconciliation measure, a bill just passed by Congress which will iron out some key differences between the House and Senate versions.

So while the healthcare reform package has some imperfections, its landmark passage is likely to improve the lives of millions of Americans, and will serve as an important framework by which to build upon. Don’t forget to call Congresswoman Susan Davis and Congressman Bob Filner to thank them for their courageous votes - www.house.gov.

Carlos Marquez is the Director of Community Programs & Public Affairs at The Center, where he oversees public policy and community programs. Prior to joining The Center, he worked in Government and Community Affairs for the Service Employees International Union, Local 221, and has also served as a Public Policy Associate for the United Way of America and a Research Associate for the ACLU’s National Legislative Office.