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Local LGBT groups assist with Obamacare

Whitman-Walker, Us Helping Us, D.C. Center helping uninsured sign up

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David Franco, gay news, Washington Blade

Local businessman David Franco was among several D.C.-area advocates who spoke at a news conference at the National Press Club on Tuesday to draw attention to what they consider the strong advantages of the Obamacare program. (Washington Blade file photo by Michael Key)

At least seven D.C.-based LGBT or LGBT-friendly organizations sprang into action on Tuesday to help members of the LGBT community and people with HIV choose a health insurance plan under the controversial U.S. Affordable Care Act that’s better known as “Obamacare.”

Similar to reports surfacing from across the country, officials from the local groups said some of their clients encountered computer glitches on the website for D.C. Health Link, the city’s online health insurance marketplace or “exchange” on its first day of operations on Tuesday.

But all of the officials contacted by the Blade said they were optimistic that the exchange program in D.C. and those in neighboring Maryland and Virginia would soon be operating smoothly and would be an important resource for LGBT people looking for health insurance.

“I’m excited about it,” said Ron Simmons, executive director of the D.C.-based Us Helping Us, an HIV services organization that reaches out to black gay men.

“We have so many clients who don’t have health insurance,” Simmons said. “If you are HIV positive you need a certain type of insurance, and we are ready to help people choose the best policy suited for their needs.”

Ron Simmons, Us Helping Us, Whitman-Walker Health, gay news, Washington Blade

Ron Simmons, president/CEO of Us Helping Us (Washington Blade photo by Michael Key)

Us Helping Us is one of five D.C.-based organizations that received a grant from the D.C. Health Benefit Exchange Authority to recruit members of the LGBT community to sign up for insurance under the Obamacare program. The grant calls on the five groups — as well as another 30 organizations that received grants to work with other constituencies — to help their clients navigate the complicated process of choosing the best possible insurance plan.

The other organizations that received grants to work with the LGBT community on the Obamacare program are Whitman-Walker Health, D.C. Care Consortium, Damien Ministries and Health HIV.

Health HIV, a new national AIDS advocacy organization located in the Dupont Circle area, applied for its grant in partnership with the D.C. Center for the LGBT Community and Westminster Presbyterian Church’s START program. The START program provides HIV/AIDS-related services with a special outreach to people with substance abuse problems.

“This is an important opportunity to engage our communities in a conversation about healthcare and for us all to better understand the changes that are taking place in the healthcare system,” said David Mariner, executive director of the D.C. Center.

“Our goal is to help 300 individuals enroll in a healthcare plan and to make the process as simple as possible for them,” Mariner said.

Simmons of Us Helping Us said his group has a goal of helping to enroll 1,000 people on a health insurance plan through the D.C. Health Link system during the nine-month-long grant period.

“We will have town hall meetings,” said Simmons. “We will go to the clubs. Our purpose is to help people enroll in the plan best for them.”

Under the Affordable Care Act’s various provisions, Tuesday, Oct. 1, became the first day that the health insurance exchanges opened for business, enabling people to review dozens of options for insurance plans. Consumers may sign up for a plan between now and next March during the program’s first annual open enrollment period. Insurance policies won’t go into effect until Jan. 1.

In order to receive a policy that begins Jan. 1, people must sign up and pay their first monthly premium by Dec. 15, government officials in charge of the program said. People may still sign up between Dec. 15 and March 31, with their policy taking effect at the first day of the following month. After the March 31 deadline, enrollment in the program will be closed until October 2014.

Experts monitoring the system have said the cost of premiums and additional payments such as deductibles and co-payments for doctor visits and prescription drugs vary widely with the different options available. But those familiar with the program say the costs so far appear to be significantly lower than health insurance available in the past in the private market.

Carl Schmid, deputy director of the AIDS Institute, a national AIDS advocacy organization, noted that low-income people may now enroll in Medicaid in the states that have agreed to expand their Medicaid programs under a non-mandatory provision of the Affordable Care Act. D.C. and Maryland opted to become part of the expanded Medicaid program while Virginia declined to do so.

Schmid points out that prior to the Affordable Care Act’s Medicaid provision, which took effect last year, low-income people with HIV who didn’t have private health insurance were not eligible for Medicaid unless they were medically disabled with an AIDS diagnosis.

“So now people with HIV who don’t have full-blown AIDS qualify for Medicaid,” Schmid said. “Our goal, of course, is to keep these people healthy.”

Carl Schmid, AIDS Institute, gay news, Washington Blade

AIDS Institute Deputy Executive Director Carl Schmid (Washington Blade file photo by Michael Key)

Schmid and others familiar with the Obamacare program note that in Virginia and other states that chose not to participate in the expanded Medicaid program, people with incomes below a certain federally defined level are eligible for federal subsidies to help pay for their insurance premiums and co-pays.

Erin Loubier, director of public benefits and senior managing attorney for Whitman-Walker Health, said people with HIV and LGBT people whose income levels may not make them eligible for the subsidies will benefit from another provision of the healthcare law already in effect.

“Anyone living with HIV or another chronic health condition will be able to get insurance,” she said, noting that prior to the Obamacare law insurance companies routinely rejected people with a pre-existing condition.

She said the generally lower prices for premiums through the exchanges will also benefit those who aren’t eligible for subsidies.

Under its grant from the D.C. Health Benefit Exchange Authority, Whitman-Walker will provide its clients as well as non-clients the services of trained “navigators” or “assisters” to help people choose the best insurance policy through D.C. Health Link. According to Loubier, Whitman-Walker will also provide training for people to become navigators and, similar to Us Helping Us, will reach out into the community to recruit people to sign up for insurance under the Obamacare program.

“The role of these assisters is critical,” she said. “Even computer savvy people may not be able to navigate the system by themselves.”

Guy Westin, executive director of D.C. Care Consortium, which provides services to people with HIV, said his group is providing navigator services to individuals as well as non-profit community organizations about the enrollment process for Obamacare.

D.C. gay businessman David Franco, owner of the clothing store chain Universal Gear and the real estate development company Level Two, said he was pleased to discover that prices announced so far by insurance companies offering employer health plans for small businesses are lower than previously available plans.

“I was able to see in a matter of 15 minutes with a couple of clicks on my keyboard what my rate would be and compare that to an equivalent plan and see the savings that are offered by different insurance companies,” Franco said.

“So the fact that you’ve got this open, free market has really created this price competition, and it’s going to drop the overall cost for the plan for all of my employees,” he said.

Franco was among several D.C.-area advocates who spoke at a news conference at the National Press Club on Tuesday called by D.C. Health Link and the healthcare consumers’ group Families USA to draw attention to what they consider the strong advantages of the Obamacare program.

Similar to Americans across the country, local LGBT advocates working on the Obamacare program say some LGBT people will likely be surprised and put off when they realize they will be subjected to a $95 tax penalty from the IRS in 2014 if they don’t have insurance and fail to buy a policy under the new program.  The penalty for not having insurance in 2015 goes up to $700.

Federal officials in charge of Obamacare point out that people who already have insurance either through their employer or on the private market and people already on Medicaid or Medicare will not be required to do anything under the new program. Their insurance status will remain as it is, officials said.

Following is a list of the seven D.C.- based organizations known to be providing services to the help the LGBT community and people with HIV access the Obamacare program, including the process of singing up for an insurance plan. Officials with the groups say it’s preferable to call first for an appointment but walk-ins are accommodated when possible.

 

Whitman-Walker Health

1701 14th St., N.W.

202-745-7000

 

Us Helping Us

3636 Georgia Ave., N.W.

202-446-1100

 

D.C. Care Consortium

7059 Blaire Road, N.W., Suite

202-223-9550

 

Health HIV

2000 S St., N.W.

202-232-6749

 

Damien Ministries

2200 Rhode Island Ave., N.E.

202-526-3020

 

D.C. Center for the LGBT Community

1318 U St., N.W.

202-682-2245

 

START Program at Westminster Presbyterian Church

400 I St., S.W.

202-863-8450

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D.C. urges gay, bi men, trans women to get Monkeypox vaccination

Majority of local cases are men who have sex with men

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D.C. Mayor Muriel Bowser on Monday urged gay and bi men and trans women to get vaccinated for Monkeypox. (Blade file photo by Michael Key)

D.C. Mayor Muriel Bowser and the city’s Department of Health announced that beginning on Monday, June 27, a limited number of appointments can be made for monkeypox vaccinations and that gay and bisexual men and transgender women who have sex with men are urged to get vaccinated.

In a statement released on Monday, the mayor and health department said Monkeypox vaccinations offered by the city are free and available Tuesdays, Thursdays, and Sundays between 1-8 p.m. at the city’s health department facility at 7500 Georgia Ave., N.W. It says the appointments are for eligible D.C. residents and can be made at PreventMonkeypox.dc.gov.

“Monkeypox is a rare, but potentially serious viral illness that can be transmitted from person to person through direct contact with bodily fluids or monkeypox lesions/rash,” the statement from the mayor and DOH says, “Monkeypox can spread during intimate contact between people, including respiratory secretions during prolonged face-to-face contact, during intimate physical contact like sex, kissing, or hugging, as well as touching fabrics and objects during sex that were used by a person with monkeypox, such as bedding and towels,” the statement says.

According to the statement, the initial symptoms of monkeypox often include flu-like symptoms such as fever, headache, muscle aches and swollen lymph nodes, followed by a rash and skin lesions.

“Although the majority of cases do not require hospitalization, monkeypox is dangerous, highly contagious, and uncomfortable,” the statement says. “While monkeypox can spread to anyone, the majority of current cases in the District are in men who have sex with men,” it says.

The DOH and mayoral statement says that to be considered eligible for the monkeypox vaccination provided by the city, persons must be a D.C. resident, 18 years of age or older and must fall within these categories:

• Gay, bisexual, and other men 18 and older who have sex with men and have had multiple (more than one) sexual partners or any anonymous sexual partners in the last 14 days

• Transgender women or nonbinary persons assigned male at birth who have sex with men

• Sex workers (of any sexual orientation/gender)

• Staff (of any sexual orientation/gender) at establishments where sexual activity occurs (e.g., bathhouses, saunas, sex clubs).

The statement says upon arrival at the vaccination site, proof of D.C. residency will be required and could include an identification card with a D.C. address, a utility bill or other mail with the person’s name on it and a D.C. address, or a current D.C. lease or mortgage with the person’s name on it.

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Gay doctor elected AMA president-elect

Dr. Jesse Ehrenfeld joined organization 22 years ago

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Dr. Jesse M. Ehrenfeld has been named president-elect of the American Medical Association (Photo courtesy of the American Medical Association)

Physicians and medical students have elected Wisconsin-based anesthesiologist Dr. Jesse Ehrenfeld as the first openly gay president-elect of the American Medical Association (AMA). 

Ehrenfeld was elected June 14 at the AMA House of Delegates’ annual meeting.

“Well, it’s certainly just an amazing feeling to know that you’ve got the confidence of your colleagues from such a broad array of practice types of modalities and perspectives,” Ehrenfeld told the Washington Blade during a telephone interview. “The association is a very diverse and increasingly diverse organization, and that’s a good thing. It’s more representative of the country and to see such broad support for a vision to move forward was really sort of heartening for me.”

The anesthesiologist and LGBTQ health expert will also serve as the first openly gay AMA president when he steps into the position later this month.

“When I joined the AMA 22 years ago, roughly, I didn’t think it was possible that a gay person could be the AMA president. And certainly 175 years ago, when the AMA was founded, that felt like something that wouldn’t have been possible,” Ehrenfeld said. “And so, to look at how the association, how medicine, health professional organizations have evolved, it’s pretty remarkable when you look at what that has looked like, and that’s a reflection of society in general. But certainly, you know, another pink ceiling has been shattered.”

Ehrenfeld previously served on the AMA’s Board of Trustee’s Executive Committee. He also worked on the AMA Recovery Plan for America’s Physicians; a long-term project that was unveiled at the annual meeting.

“A big component of that is helping physicians prepare the health system so that we can make sure that we can renew our commitment to achieving optimal health for all,” Ehrenfeld said. “To do that, we have to make sure that we prioritize the needs of physicians to improve patient care.”

Ehrenfeld is an associate dean and tenured professor of anesthesiology at the Medical College of Wisconsin and has advocated for issues affecting multiple marginalized communities, such as transgender representation in the military. He emphasized the importance of diversifying the medical field to ensure better service for patients.

“We need folks from every community but particularly marginalized communities to step forward and enter the profession. That’s how patients get better care,” Ehrenfeld said “There’s data that when we have a more diverse healthcare workforce, and when we’re a more diverse community, that those health disparities inequities, actually start to go away.”

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Take Pride in Your Health: Tips from a Primary Care Physician

Navigating health care can be daunting, especially for those who identify as LGBTQ+. Historically, the LGBTQ+ community has been marginalized and discriminated against, which has led to mistrust and unease for many who seek medical care. 

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Navigating health care can be daunting, especially for those who identify as LGBTQ+. Historically, the LGBTQ+ community has been marginalized and discriminated against, which has led to mistrust and unease for many who seek medical care. 

In Washington, DC, individuals identifying as LGBTQ+ comprise 9.8% of the population, a greater percentage than in any state. Individuals from this community are almost three times more likely to report poor quality of care and discrimination by healthcare providers. Nearly three in 10 of those who identify as transgender reported being refused healthcare because of their gender identity. Patients who identify as LGBTQ+ are less likely to seek preventive services such as cancer screenings and treatment for chronic conditions. And are more than two times more likely to delay getting care.

As we recognize Pride Month, I want to offer a few suggestions for finding healthcare providers committed to care equity and navigating the healthcare system so you can get the support you need to be healthy. Below are three tips to guide your care.

Find a doctor who’s an ally: The first important step is to find a doctor with whom you can speak honestly about your sexual health, gender identity, and health concerns. Look for a caring practitioner with special expertise in treating the LGBTQ+ population. Review the physician’s profile, looking for their level of interest and experience in treating the LGBTQ+ community. To get started with a new provider, I suggest scheduling a meet-and-greet appointment with a primary care provider to review your personal medical history, family history, specific concerns and health goals.  From there, you and your doctor can establish a health regimen that includes any necessary lab work, screenings, and office visits to best support your total health. Gender-affirming healthcare, if desired, should be discussed. 

Kaiser Permanente offers Pride Medical at Capitol Hill Medical Center, a welcoming, judgment-free, compassionate, and supportive medical practice devoted to meeting the unique health care needs of adult patients who identify as LGBTQ+. Kaiser Permanente’s gender-affirming care program, Gender Pathways, takes an innovative approach to providing care to transgender, nonbinary, and gender-expansive patients. Their services include behavioral health care, hormone replacement therapy, and gender-affirming surgeries. 

Know your risk factors: Understanding the unique health needs within the LBGTQ+ community is key to staying healthy. As people within the LGBTQ+ population face daily discrimination, some cope with these challenges by using tobacco and substances. In fact, there are higher rates of substance abuse for individuals who identify as LGBTQ+ than among heterosexual adults.Some populations within the LGBTQ+ community have a higher risk of sexually transmitted diseases, including HIV. The LGBTQ+ population also has a higher risk of developing certain cancers.To address your specific health risks and goals, your doctor can develop an individualized care plan that will include preventative screenings and routine appointments designed to identify and address problems early, leading to better health outcomes.Kaiser Permanente’s electronic medical record system proactively identifies the need for general health screenings and sends personalized reminders.

Manage your mental health: At Kaiser Permanente, we encourage preventive health measures to avoid developing health conditions like heart disease or cancer – and the same goes for mental health. Members of the LGBTQ+ group are more than twice as likely as cisgender heterosexual adults to have a mental health condition, such as depression or anxiety disorders. And, adults who identify as transgender are nearly four times as likely as cisgender adults to have a mental health condition. You can manage stress through exercise and using self-care digital apps, such as Calm or myStrength, free to Kaiser Permanente members. These tools can guide meditation and find support for building resilience, setting goals, and making minor changes to improve sleep, mood, and relationships. Prioritize frequent exercise, talking to someone you trust, journaling, and making time for self-care. As always, talk to your doctor if your mood or behavior changes affect your ability to participate in everyday activities.

You can become a self-advocate and receive the healthcare you need by establishing a rapport with a doctor you trust, knowing your specific health risks, and managing your mental health. Live a joyful, healthier life by seeking support from a primary care doctor and maintaining your routine screenings. Learn more about Pride Medical and LGBTQ+ care at Kaiser Permanente here. 

Dr. Keith Egan, a primary care physician at Kaiser Permanente and assistant medical director of Pride Medical at Capitol Hill.

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