The final health care reform package the U.S. House approved Sunday lacks of any LGBT-specific or HIV/AIDS language passed last year in the House version of the bill.
Gone from the final package, which the House passed by a 219-212 vote, is a provision eliminating the tax paid on domestic partner health benefits received under an employer plan as well as language authorizing states to cover low-income people with HIV before they develop AIDS.
Also missing is language providing for non-discrimination in health care and a provision authorizing the federal government to collect health care data on the LGBT population.
A House Democratic leadership aide, who spoke on the condition of anonymity, said the early treatment for HIV and data collection provisions weren’t included in the final bill because they had no budgetary implications and thus were ineligible under parliamentary rules.
Congress is passing health care through the reconciliation process so only 51 votes are required in the Senate for passage for the final bill as opposed to 60.
Under this process, any changes the House wanted to make to the previously approved Senate bill had to be part of a sidecar reconciliation package. But under reconciliation, only matters related to the budget are eligible for a vote.
As for the domestic partner tax elimination provision, which may have budgetary implications because it deals with taxation, the House aide deferred to the White House on why the provision wasn’t included in the final bill. A White House spokesperson, however, declined to comment.
Although the LGBT and HIV/AIDS provisions unique to the House legislation weren’t included in the reconciliation package, the final bill has one provision aimed to help to HIV/AIDS community that was included in both the House and Senate versions of the legislation.
The language would enable AIDS Drug Assistance Program expeditures to count toward out-of-pocket expenses under Medicare Part D. In other words, people with HIV/AIDS on Medicare who receive help purchasing HIV drugs would have a lesser burden for other prescription drug costs.
Other provisions in the final bill less explicitly directed at people with HIV/AIDS would assist people living with the condition.
The final health bill eliminates discrimination based on health status or pre-existing conditions, such as HIV/AIDS. Additionally, the bill expands Medicaid eligibility for people with incomes below 133% of the federal poverty level, allowing more low-income people with HIV to access Medicaid and its prescription drug coverage.
Although the House LGBT provisions are gone from the final bill, advocates on Capitol Hill pledged to work to pass this language through other legislative vehicles.
In a statement, Jerilyn Goodman, spokesperson for lesbian Rep. Tammy Baldwin (D-Wis), an advocate of the LGBT language, said the lawmaker looks forward to passing the health care bill and “move on to pursue every available option to pass the other LGBT provisions.”
In a blog posting on the Human Rights Campaign website, Brian Moulton, HRC’s chief legislative counsel, said his organization is “deeply disappointed” the LGBT language was omitted. Still, he said HRC would continue working for this language.
“While we are saddened that the House has abandoned provisions that would make care more accessible and affordable to our community, we recognize that the health reform measure will still help all Americans, including LGBT people,” he said. “Important reforms like eliminating pre-existing condition limitations and expanding Medicaid will significantly impact people living with HIV and AIDS.”