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How Obamacare repeal would hurt LGBT people

Trans, HIV/AIDS patients at risk if ACA goes down

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President-elect Donald Trump (left), U.S. House of Representatives Speaker Paul Ryan (R-Wis.) and U.S. Senate Majority Leader Mitch McConnell (R-Ky.) have made Obamacare repeal a campaign promise. (Washington Blade file photos by Michael Key)

President-elect Donald Trump (left), U.S. House of Representatives Speaker Paul Ryan (R-Wis.) and U.S. Senate Majority Leader Mitch McConnell (R-Ky.) have made Obamacare repeal a campaign promise. (Washington Blade file photos by Michael Key)

Amid persistent fears that a Donald Trump administration would roll back LGBT advances seen under President Obama, the protections that are most likely in jeopardy can be found in Obamacare.

A top campaign promise of President-elect Trump and Republicans in Congress ā€” who will have unified control of the federal government ā€” is to “repeal and replace” the Affordable Care Act. OneĀ provision in the law ensuresĀ that transgender people have access to transition-related care; another ensures that low-income people with HIV/AIDS can obtain life-saving medication.

Section 1557 of Obamacare prohibits health care providers and insurers from discriminating on the basis of gender. The Obama administration has issued a rule interpreting that provision to bar discrimination in health care against gender non-conforming and transgender people, including for the purposes of transition-related care and gender reassignment surgery.

Mara Keisling, executive director of the National Center for Transgender Equality, said she doesn’t think “anybody knows anything right now” about what the Republicans will do, but acknowledged it will be hard forĀ them to ignore Obamacare.

ā€œSo we know the Affordable Care Act is going to be assaulted somehow,” Keisling said. “We donā€™t know if Section 1557 is, and it would just be a real shame if it was. It just basically says health care providers canā€™t discriminate on the basis of race, age, disability and sex.ā€

In the event Congress were to repeal Section 1557, Keisling said a “belt-and-suspenders” system remains in place that would help protect transgender people, includingĀ state insurance commission rulings,Ā professional association rules andĀ state non-discrimination laws under which health careĀ or public accommodations is listed.

But Keisling also said Congress could render Section 1557 moot not just by repealing it, but refusing to fund the Department & Health Human Services and the Office of Civil Rights at a level that could enforce it.

ā€œIf they decide to starve civil rights enforcement processes and functions in the federal government like the Bush administration did, that hurts us,” Keisling said.

Laura Durso,Ā senior director of LGBT research and communications at the Center for American Progress, said repeal of Section 1557 would have “devastating consequences” for many communities, but in particular transgender people, whom she said would “lose vital protections.”

“Without these civil rights protections, we could to go back to a time when science and compassion take a back seat to misinformation and ideology, and we must demand better for our transgender siblings,” Durso said.

Durso said prior to the Affordable Care Act, transgender people “overwhelmingly reported negative experiences with the health insurance market due to denials of coverage,” but after Obamacare ā€” in part because of Section 1557 ā€” the rate of insurance for low- and middle-incomeĀ transgender people dropped from 59 percent in 2013 to 35 percent in 2014.

Undoing Medicaid could hurt people with HIV/AIDS

ObamacareĀ also expandedĀ Medicaid to cover individuals withĀ incomes at less thanĀ 133 percent of the poverty level. After the U.S. Supreme Court in 2012 upheld the individual mandate in the Affordable Care Act, states could elect whether or not to take part in the expansion. Thirty-one states andĀ D.C. elected to expand Medicaid.

According to an October report from the Kaiser Foundation, Medicaid is estimated to cover more than 40 percent of people with HIV in care. Additionally, Medicaid accounts for 30 percent of all federal spending on HIV care, and when combined with the statesā€™ share of spending, is the second largest source of public financing for HIV care in the United States, the report says.

Carl Schmid, deputy executive director of the AIDS Institute, said manyĀ people with HIV/AIDS depend on Medicaid ā€” both for drug and doctor care ā€” because “a lot of people with HIV are very poor,ā€ raising fears about how Trump mightĀ undo efforts toĀ address the epidemic.

ā€œWeā€™re obviously very concerned about how heā€™s going to address HIV/AIDS issues ā€” both domestically and globally ā€” and then the Affordable Care Act is just so important for people living with HIV or at risk of HIV, and I donā€™t think they know the magnitude,” Schmid said. “And I think, hopefully, cooler, smarter heads will prevail as you get into the details.ā€

Schmid said the Affordable Care Act also is effectiveĀ in addressing the HIV/AIDS epidemic because it covers preventive care, including HIV testing,Ā with no patient cost-sharing.

One idea Republicans have proposed is changing Medicaid to a block-grant system in which the federal government would discontinueĀ its open-ended commitment to help states cover costs in exchange for certain commitments and, instead, provide states with annual lump sums, freeing them up to run the program as they wish.

But Schmid said that would be bad for people with HIV/AIDS because some states, he said, want to eliminate the single tablet regime in favor of less costly individual components, which would require people with the disease to take more tablets per day.

ā€œWeā€™re concerned about the block-granting because weā€™re going to lose those protections they have in place at the federal level,” Schmid said.

In the event Congress rolled back Medicaid, Schmid said there would be more pressure on the Ryan White Care Act, which before Obamacare covered low-income people with HIV/AIDS, as “the payer of last resort.”

“Under the ACA and Medicaid expansion, Ryan White clients have been able to gain coverage under Medicaid for health care and medications, and Ryan White has been able to provide additional support services, like case management, transportation and food,” Schmid said. “If Medicaid was reduced, those clients would have to go back to reliance on the Ryan White Program.”

Both Section 1557 and the Medicaid expansion could be particularly vulnerable in the 115th Congress. A Senate Democratic leadership aide said both components of Obamacare can be undone through the reconciliation process, which would mean only 51 votes ā€” not 60 ā€” would be needed invoke cloture to move forward with repeal of the provisions.

Keisling, however, said her read of Section 1557 is that it would require 60 votes to undo, which likely means Congress would only get rid of it by repealing Obamacare in its entirety.

ā€œI think if Section 1557 goes, the whole thing goes,” Keisling said. “Itā€™s not the funding part of the bill, itā€™s just about how as we have this system that weā€™re trying to make better, it shouldnā€™t be a discriminatory system.”

Will Republicans follow through on repeal?

With an estimated 20 million people enrolled in health insurance plans as a result of Obamacare and that number growing during the open enrollment, it remains to be seen whether Trump and Republicans will make good on their promise to undo the law.

U.S. House Speaker Paul Ryan (R-Wis.) was cagey during a news conference on Thursday when asked about plans to repeal Obamacare during the 115th Congress.

“It’s a great question,” Ryan said. “That’s one that we’re going to be dealing with all year long. This is ā€” it’s too early to have, to know the answer to, how fast can Obamacare relief occur. What we’re focused on is how we get Obamacare repealed and what we replace it with, so that we can get that relief to the American families as fast as possible.”

David Popp, a spokesperson for Senate Majority Leader Mitch McConnell (R-Ky.), said he has no “announcements or updates on any legislative action for the 115th Congress” when asked by the Washington Blade about plans to repeal Obamacare.

Republicans may feel pressured to act on repeal. A Morning Consult exit poll showed 58 percent of voters think the law should beĀ repealed, compared to 36 percent of voters who think the law should remain as it is or be expanded.

During an interview last week on “60 Minutes,” Trump said he wants to keep some of the more popular components of Obamacare in place, such as the ban on discrimination based on pre-existing conditions and the ability of parents to keep their kids on a family plan until they reach age 26.

“It’ll be just fine. we’re not going to have, like, a two-day period and we’re not going to have a two-year period where there’s nothing. It will be repealed and replaced. And weā€™ll know. And it’ll be great health care for much less money. So it’ll be better health care, much better, for less money. Not a bad combination.”

But Schmid said he doesn’t see how Trump could move forward with a pledge to eliminate the individual mandate for Americans to buy health insurance if he keeps the ban on discrimination based on pre-existing conditions.

“To do that, you really have to have the individual mandate,” Schmid said. “They go together, and I donā€™t think they realize that because the insurance companies donā€™t want just sick patients. They need everyone to make it work.”

President Obama during a news conference last week said Republicans who have made repeal of Obamacare theĀ “Holy Grail” of the campaignĀ will face difficult questions that may stymie them now that they have the opportunity to act on that goal.

“It’s one thing to characterize this thing as not working when it’s just an abstraction,” Obama said. “Now, suddenly, you’re in charge and you’re going to repeal it. OK, well, what happens to those 20 million people who have health insurance? Are you going to just kick them off and suddenly they donā€™t have health insurance? And in what ways are their lives better because of that?”

Katie Keith, a steering committee member of pro-LGBT Obamacare group Out2Enroll, said the current period of open enrollment presents an opportunity for LGBT people to enroll in plans and demonstrate support for the law.

“In particular, Section 1557 bans transgender exclusions in 2017 marketplace plans, which is an unprecedented new protection that will improve access to transition-related care,” Keith said. “That’s why Out2Enroll is all in to encourage trans people to enroll before the Dec. 15 deadline. If folks have been holding out on getting covered in the past, we get it, but we are encouraging everyone, especially trans people, to consider enrolling this year.”

Whatever the plans of Republicans and the Trump administration, Keisling said LGBT advocates are prepared to advocate to make the case the existing protections under Obamacare should remain in place.

“We all know we have to work to advocate harder than ever and meet with the new administration, advocate with Congress, advocate through professional medical and health care associations, and I think all of us, know that,” Keisling said.

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Miscellaneous

What it means to be an active ally to your LGBTQ+ co-workers TEST

Five easy tips to help you avoid common risks

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Be sure to install baby gates if you have stairs in your home with young children. (Photo by Kasia Bialasiewicz/Bigstock)

Your home is more than just a place to eat and sleep; it’s your safe haven. As much as you might cherish your home, you should probably also recognize the potential hazards within its familiar walls. Accidents can happen in an instant, yet with a little foresight and some simple adjustments, you can transform your house into a safer haven. 

Accidents can happen anywhere, and with a few simple tweaks, you can lower risks in your space. Below youā€™ll find five tips for each room in your home to help prevent injuries, falls, and other mishaps. In short, home safety. 

This article was inspired by a shower in a rental we managed that began leaking through the kitchen ceiling below. If only the landlord had installed grab bars, right!? Below, we’ll guide you through the steps to fortify your bathroom, making it a place of relaxation without the fear of slips and falls. Then, we’ll venture into the room where the magic happens, where proper planning can ensure great nights and peaceful mornings. We’ll show you how to prevent accidents while you experiment becoming the next Gordon Ramsey. And weā€™ll include a few surprising solutions for those other rooms that hold their own unique hazards, offering solutions to safeguard against unexpected mishaps.

Bathroom Safety

Install Grab Bars: Adding grab bars near the shower and toilet can provide essential support for family members of all ages. Not only can they help with getting in and out, but they can help provide stability when washing. Make sure they are securely anchored to the wall.

Non-Slip Mats: Place non-slip mats inside the shower and bathtub to prevent slips. They’re a small investment that can save you from falls and head injuries.

Adjust Water Temperature:  Ensure your hot water is set to a safe temperature to avoid scalding. The hot water heater should be set to around 120Ā°F (49Ā°C)l, the middle setting on many water heater settings. 

Medicine Cabinet Locks: If you have young children, use childproof locks on your medicine cabinet to keep harmful substances out of reach.

Proper Lighting: Ensure there’s adequate lighting in the bathroom to avoid trips and falls during nighttime visits. Nightlights can be a simple and effective solution. 

Bedroom Safety

Clear Pathways: Keep pathways in the bedroom clutter free to prevent tripping. Ensure there’s enough space to move around comfortably, particularly getting around the bed.  Be aware where all furniture is when walking around to avoid stubbed toes, particularly at night.

Secure Rugs: If you have throw rugs, use rug grippers or double-sided tape to keep them from slipping. Loose rugs are a common trip hazard. 

Bed Rails: For anyone at risk of falling out of bed, consider installing bed rails to provide extra support and prevent falls.

Nightstands with Drawers: Opt for nightstands with drawers to keep essential items.  This reduces the need to get out of bed at night, minimizing the risk of falls, as you race to grab what you need and not lose a momentā€™s rest.

Fire Safety: Install battery-operated smoke detectors in the bedrooms if there are none. Make sure to install them 36 inches away from an air vent or the edge of a ceiling fan.  Also six inches away from the joint between the wall and ceiling.  And test smoke detectors regularly.

Kitchen Safety

Non-Slip Flooring: Choose slip-resistant rugs in the kitchen, especially in areas where spills are common. Mats near the sink and stove can also help and you can often buy them fairly cheaply at Costco.

Childproof Cabinets: If you have little ones, use childproof latches on cabinets and drawers to prevent them from accessing potentially hazardous items.

Anti-tip brackets: Install an anti-tip bracket behind the range. These are often used when children are in the home. Although they are less likely to open the oven door and use it as a step stool to get to the stove-top, adults can also benefit from installing these. 

Adequate Lighting: Proper lighting is crucial in the kitchen to avoid accidents. Under-cabinet lighting can illuminate work areas effectively.

Secure Heavy Items: Ensure heavy pots and pans are stored at waist level to prevent straining or dropping them from high shelves.

Sharp Object Storage: Keep knives and other sharp objects in a secure drawer or block. And handle all sharp items with extreme care, even when washing and drying. These steps reduce the risk of accidental cuts.  

Other Safety Tips

Furniture Anchors: Secure heavy furniture, like bookshelves and dressers, to the wall to prevent tip-overs, especially if you have young children.

Adequate Outlets: Check for damaged outlets and replace them promptly. Avoid overloading circuits with too many devices. Install placeholder plugs in outlets to prevent young curious fingers (or tongues?) from going inside an electrical outlet.

Stair Gates: If your home has stairs, install safety gates at the top and bottom to prevent falls, especially if you have toddlers or pets to keep them off of the stairs when you cannot monitor them.

Emergency Escape Plan: Develop and practice an emergency escape plan with your family, including a designated meeting place outside.

Carbon Monoxide Detector:  If your home burns any fossil fuels for heating or appliances, install carbon monoxide detectors in common areas of your home to detect this odorless gas. The D.C. building codes require this if you use a fireplace or if you have an attached garage. In essence, if there is any potential source of carbon monoxide in the home, be sure to install these detectors.

Remember, a safer home not only prevents accidents but also provides peace of mind for you and your family. Implement these simple tips to create a secure environment in every room of your house.

With these practical tips and a few adjustments, you can significantly reduce the risk of injuries and falls in your home. Enjoy peace of mind in your now much safer haven.

Scott Bloom is owner and senior property manager of Columbia Property Management.

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Celebrity News

Lizzo makes $50K donation to Marsha P. Johnson Institute

Singer is vocal LGBTQ ally

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Lizzo at the 65th Grammy Awards (Screenshot from the Grammy Awards)

When Lizzo sings “If I’m shinin,’ everybody gonna shine,ā€ in her hit song, “Juice,” she means it. Proof of that came this week on Instagram when the LGBTQ ally announced the first winner of her annual Juneteenth Giveback Campaign is the Marsha P. Johnson Institute, a national nonprofit based in Richmond, Calif., dedicated to the protection and defense of Black transgender people. 

And she did so in song: ā€œOn the first day of Juneteenth, Lizzo gave to me,ā€ she sang in her video, posted Tuesday, as she revealed her $50,000 gift to MPJI.

ā€œThatā€™s right, we know who Marsha P. Johnson is. We know what Marsha P. Johnson has done for the LGBTQ, emphasis on that ā€˜T,ā€™ Q community,ā€ said Lizzo to her 13.5 million followers. ā€œThank you so much to the people at the Marsha P. Johnson Institute. You deserve this, and I hope this helps you so much as you help protect our Black trans family.ā€ 

ā€œWhat the Marsha P. Johnson Institute does is protects and defends the rights of Black transgender people. They do this by organizing community, advocating for the people, and creating an intentional healing community, developing transformative leadership and promoting collective power,ā€ she said. 

ā€œWe are overjoyed for the shoutout from Lizzo today, the generosity of her sharing her platform and the recognition of MPJI and its work,ā€ said Elle Moxley, MPJIā€™s executive director. ā€œThe resources from this campaign will ensure the protection and defense of Black transgender people continue at a time where it is so vitally needed. We are so grateful for the support of Lizzo and her fans.ā€

As one of Time Magazineā€™s Persons of the Year for 2019 and a 2023 Grammy winner, Lizzo is more than a pop star but an inspiration to millions of fans for her body-positive attitude, her self-confidence on stage and in her videos, her empowering music and her activism. Sheā€™s also the founder of her own clothing line, Yitty. In 2021, she made headlines when she publicly corrected a paparazzo for using ā€œshe/herā€ pronouns and misgendering Demi Levato.

As part of her campaign, now in its 4th year, Lizzo recognizes Black-led grassroots organizations and businesses and encourages her fans to join her in supporting each of the five organizations she highlights this week. Fans who take action by donating are  entered into a drawing for an all-expenses paid trip to see her perform at Fuji Rock in Japan later this year. 

This weekā€™s other nonprofits receiving gifts are: Black Girls Smile, Sphinx Music, the University of Houston and Save Our Sisters United.

Find out more about Lizzoā€™s 4th annual Juneteenth Giveback Campaign by clicking here.

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Anne Heche dies after removal from life support

Actress dated Ellen DeGeneres in late 1990s

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(Screenshot/YouTube Inside Edition)

Actress Anne Heche died after she was removed from life support on Sunday, nearly two weeks after her Mini-Cooper crashed through a two-story house in Los Angelesā€™ Mar Vista neighborhood. Investigators with the Los Angeles Police Department believe she was intoxicated at the time.

She sustained a severe anoxic brain injury along with severe burns and was being treated at the Grossman Burn Center at West Hills Hospital, near Chatsworth in the San Fernando Valley.

The 53-year-old actress who was a star of films likeĀ “Donnie Brasco,” the political satireĀ “Wag the Dog”Ā and the 1998 remake ofĀ “Psycho,” had been declared legally dead under California law on Friday, however, her family kept her alive long enough to be an organ donor.

In a statement Friday, the LAPD announced that: ā€œAs of today, there will be no further investigative efforts made in this case. Any information or records that have been requested prior to this turn of events will still be collected as they arrive as a matter of formalities and included in the overall case. When a person suspected of a crime expires, we do not present for filing consideration.ā€ LAPD detectives had previously made public that investigators into the crash found narcotics in a blood sample taken from Heche.

The actress’s family released a statement on Friday:

“Today we lost a bright light, a kind and most joyful soul, a loving mother, and a loyal friend. Anne will be deeply missed but she lives on through her beautiful sons, her iconic body of work, and her passionate advocacy. Her bravery for always standing in her truth, spreading her message of love and acceptance, will continue to have a lasting impact,” the statement added.

Heche was married to camera operator Coleman Laffoon from 2001 to 2009. The two had a son, Homer, together. She had another son, named Atlas, during a relationship with actor James Tupper, her co-star on the TV series ā€œMen In Trees.ā€

Laffoon left a moving tribute on an Instagram reel in which he also gave an update on how their 20-year-old son Homer Laffoon is coping with the loss of his mother.

“I loved her and I miss her, and I’m always going to,” he said adding: “Homer is okay. He’s grieving, of course, and it’s rough. It’s really rough, as probably anybody can imagine. But he’s surrounded by family and he’s strong, and he’s gonna be okay.”

“Rest In Peace, Mom, I love you, Homer,ā€ the actor’s 20-year-old son, Homer, said in a statement after Heche was declared legally dead on Friday.ā€œ My brother Atlas and I lost our Mom,ā€ read the statement. ā€œAfter six days of almost unbelievable emotional swings, I am left with a deep, wordless sadness. Hopefully, my mom is free from pain and beginning to explore what I like to imagine as her eternal freedom. Over those six days, thousands of friends, family, and fans made their hearts known to me. I am grateful for their love, as I am for the support of my Dad, Coley, and my stepmom Alexi who continue to be my rock during this time. Rest In Peace Mom, I love you, Homer.ā€

Tupper, a Canadian actor who starred alongside Heche in “Men in Trees,” had a 13-year-old son,Ā Atlas, withĀ her. “Love you forever,” Tupper, 57, wrote on his Instagram post’s caption with a broken heart emoji, which shared an image of the actress from Men in Trees.

Between 1997 and 2000, Heche was also in a relationship with talk show host Ellen DeGeneres.

“This is a sad day,” DeGeneres posted on Twitter. “I’m sending Anne’s children, family and friends all of my love.” The year after her break-up with the comedian, in September 2001, Heche recounted in her memoir “Call Me Crazy,ā€ about her lifelong struggles with mental health and a childhood of abuse.

KTLA’s entertainment reporter Sam Rubin noted that over the past two decades, Hecheā€™s career pivoted several times. In 2017, she hosted a weekly radio show on SiriusXM with Jason Ellis called ā€œLove and Heche.ā€

In 2020, Heche made her way into the podcast world. She launched ā€œBetter Togetherā€ which she cohosted alongside Heather Duffy Boylston. The show was described as a way to celebrate friendship. 

She also worked in smaller films, on Broadway, and on TV shows. She recently had recurring roles on the network series ā€œChicago P.D.,ā€ and ā€œAll Riseā€ and was a contestant on ā€œDancing with the Stars.ā€

People magazine reported that several of Hecheā€™s acting projects are expected to be released posthumously.

These includeĀ “Girl in Room 13,” expected to be released on Lifetime in September,Ā “What Remains,” scheduled to be released in 2023, and HBO Max TV seriesĀ “The Idol,” created by Abel Tesfaye (The Weeknd) and Euphoria creator Sam Levinson.

In her Instagram post from earlier this year Heche stands between her sons Atlas, 13 and Homer, 20.

From KTLA:

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