CommunityPam's House Blend

Fed DOMA may leave LGBT couples out in the cold re: health care reform benefits

Here we go again — as the House vote on the $894 billion health care reform plan is looming on Saturday, a teensy problem affecting LGBTs seems to have cropped up in the language of the bill that will leave eligibility at the whim and interpretation of the Health Choices Commissioner position. (Wash Blade):

[T]he bill, H.R. 3962, uses the terms “family” and “dependent,” and advocates say the new Health Choices Commissioner – a position established in the legislation to oversee the insurance exchange – could interpret this language to mean someone’s opposite-sex spouse, but not a same-sex spouse.

For example, the section describing the retiree reinsurance program – for which employer-based programs could submit claims to the government – says claims could be made on “employment based health benefits provided to a retiree or to the spouse, surviving spouse, or dependent of a retiree.”

Brian Moulton, the Human Rights Campaign’s chief legislative counsel, said the term “dependent” and “family” in the bill are “fairly open-ended” and “leave a lot of discretion to the new commissioner to define them.”

“Certainly, there is some use of the term ‘spouse’ in the bill in some of the provisions, and certainly DOMA would control that definition of spouse,” he said. “I think there are some areas where there’s a potential there won’t be access to some of the benefits.”

Do you trust that this administration will put a person in this position that will interpret this language broadly or narrowly, given a broad interpretation will turn up the right wing spin machine?

Jerilyn Goodman, a [Tammy] Baldwin spokesperson, also said the Health Choices Commissioner could interpret “dependent” in a way that excludes same-sex couples.

“H.R. 3962, Affordable Health Care for America Act, does have the potential to interact with DOMA and affect the LGBT community,” she said. “Whether that is positive or negative, however, depends almost entirely on the administration.” Another Democratic aide, who spoke on the condition of anonymity, also said it’s “up to the administration” to determine whether same-sex couples would be included in some parts of health care reform. “Clearly, the only way to … ensure equality across the board is to repeal DOMA,” said the aide.

That said, there are key provisions in the bill that do take LGBTs and those dealing with HIV/AIDS into consideration, including:

• general non-discrimination language inclusive of sexual orientation and gender identity that prohibits discrimination by health insurers;

• a provision enabling a new assistant secretary for health information to collect health data on disparate populations, including the LGBT community, and to open public health programs and grants focused on health disparities to cover the LGBT population;

• language eliminating taxes on employer provided health coverage for LGBT people who receive coverage from a same-sex partner under an employer’s plan;

• a provision allowing people with AIDS to count drugs they receive from AIDS Drug Assistance Programs toward out-of-pocket costs to qualify them for Medicare Part D catastrophic benefits;

• and language permitting state Medicaid programs to cover low-income people with HIV before they develop AIDS.

Click over and read the rest. It’s an interesting mix of reactions to the dance that Congress is doing here; given the minimal notice that has been given in the MSM regarding LGBTs and the health care reform bill (as opposed to the right’s fixation on access to abortion, for instance), I’m glad this language is out here to evaluate before the vote.

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Pam Spaulding

Pam Spaulding