Last Thursday’s 5-4 decision let stand all aspects of the legislation that is considered one of the cornerstones of President Obama’s administration.
Among the provisions of the 2010 Affordable Care Act is the inclusion of LGBT-inclusive nondiscrimination protections in the proposed state insurance exchanges, as well as a ban on sex-based discrimination in the health-care system, which federal agencies have in other cases interpreted to include discrimination based on gender identity. The law would prevent insurance companies from denying access to insurance for those who have a pre-existing condition, such as HIV or those who are transgender, and from capping the dollar amount of benefits that people can receive.
It calls for enhanced collection of health data on communities facing health disparities and increased emphasis on cultural-competency training for healthcare professionals, and would focus resources on HIV prevention.
ACA will also funnel dollars to community-based health centers.
Mazzoni Center executive director Nurit Shein said her agency is “thrilled” at the ruling.
“The legislation will extend coverage to millions of previously uninsured Americans, including many from the LGBT communities, and will offer them access to both primary and specialty care, which is so important,” she said. “It also means that insurers can no longer deny coverage based on pre-existing conditions, which had been a serious obstacle for individuals with HIV.”
“Today’s decision will have an enormous impact on access to high-quality care for LGBT people and their families,” said National Center for Lesbian Rights executive director Kate Kendell in a statement last Thursday. “The ACA represents the most significant effort ever undertaken to address health disparities for LGBT patients seeking care. These changes make it substantially easier for low-income people and people with pre-existing conditions to access care, issues that are crucially important for the LGBT community.”
In addition to the LGBT-specific areas, the law also offers benefits such as enhanced patients-rights protections, the allowance of young adults to remain on their parents’ insurance until age 26 and the expansion of Medicaid eligibility — although the Supreme Court found that states can opt out of that final provision.
National Minority AIDS Council director of legislative and public affairs Kali Lindsey called the Supreme Court ruling a “significant victory in the effort to provide quality healthcare to all who need it,” but cautioned that the opt-out Medicaid expansion is harmful.
“The court’s decision that the Medicaid expansion must be voluntary means that millions of low-income Americans, including thousands living with HIV, may still lack access to the program,” Lindsey said. “The law’s subsidies, which are aimed at helping individuals purchase insurance through state health exchanges, were not designed to cover those who would have otherwise been eligible for Medicaid under the expansion.”