National Coalition for LGBT Health Advocacy Brief – December 20, 2019

Appeals Court Strikes Down ACA Individual Mandate

On December 18, a federal appeals court ruled against a central provision of the Affordable Care Act (ACA) – the requirement that everyone in the U.S. maintain health insurance. Though damaging, the court ruled that striking down the individual mandate does not invalidate the rest of the ACA, including protections for people with pre-existing conditions and financial assistance for those who cannot afford health insurance. This decision contradicts a previous ruling by a Texas judge that the ACA could not be separated from the individual mandate, and a repeal of this provision meant a repeal of the law as a whole. In the December 18 ruling, the court sent the case back to the Texas judge to review and determine what parts of the ACA can survive without the individual mandate. California Attorney General, Xavier Becerra has challenged the appeals court ruling and is petitioning the Supreme Court to take up the case in the hopes of preserving the ACA in full. These events leave the fate of the law uncertain heading into the 2020 election. If the law is thrown out, it is estimated that 17 million people could lose their insurance and as many as 50 million people with preexisting conditions could face discrimination, including denial of coverage and unfair pricing, from their insurers.

Read more via the New York Times

Read more via Kaiser Health News

The National Coalition for LGBT Health Signs Letters Opposing Discrimination and Decreased Health Care Access

The National Coalition for LGBT Health has signed two letters from the Federal AIDS Policy Partnership’s HIV Health Care Access Working Group responding to recent actions by the Trump Administration and the state of Tennessee to inhibit health equity and reduce health care access in the U.S. The first letter responds to the U.S. Department of Health and Human Services (HHS) Notice of Proposed Rulemaking and Notification of Nonenforcement that will remove anti-discrimination requirements for HHS grant-funded programs – including HIV/AIDS prevention and treatment services, and community health centers – enabling service providers to discriminate on the basis of sex, sexual orientation, and gender identity. This letter was submitted during the public comment period for the proposed HHS rule, which closed on Thursday, December 19.

The second letter was to the state of Tennessee – the first state to file for block grant funding for its Medicaid program under the Trump Administration via a 1115 Waiver application. In contrast to existing funding structures, which require the federal government to chip in to cover the costs when Medicaid expenditures exceed expectations, a block grant is paid out as a one-time lump sum, leaving states wholly responsible for any program costs beyond that amount. Block grants were at the heart of Congressional Republicans’ 2017 push to repeal and replace the Affordable Care Act (ACA), and are particularly problematic during times of economic recession, when more Americans rely on Medicaid to pay their health care costs, and during public health emergencies. Comments on Tennessee’s application are due to CMS by December 27th.

The “Fairness for All Act” Doesn’t Live Up to Its Name

House Rep. Chris Stewart (R-UT) announced a new bill entitled the “Fairness for All Act” that would extend protections for religious liberty at the expense of LGBTQ people and other protected groups. Though the bill seems to guarantee increased LGBTQ protections, Stewart has received harsh criticism from human rights groups on the ground that it offers religious exemption in discrimination against LGBTQ people, people of color, women, and people of different religious faiths. It has been seen as a response to the Equality Act (H.R.5), passed by the House in May of 2019, held in the Senate where it faces extreme opposition from Senate Republicans and the Trump Administration.

Read more via the ACLU

Research Supports Link Between Discrimination and Health Outcomes in LGBTQ Communities

In a legal brief supporting recent efforts to undermine civil rights for LGBTQ individuals in court, a group of legal scholars argued that there is a lack of evidence linking discrimination to adverse health outcomes in LGBTQ communities. In a joint project, the Washington Post and Cornell University’s Center for the Study of Inequality set out to prove that claim wrong through a review of hundreds of peer reviewed articles studying the effects of anti-LGBTQ discrimination on health and well-being. 95% of the studies connected discrimination to adverse health outcomes ranging from depression and anxiety to cardiovascular disease and high blood pressure. Some of the articles also shed light on the beneficial effects of legislation supporting LGBTQ rights, for example, legalization of same-sex marriage was tied to a 7% reduction in the LGBTQ youth suicide rate.

Read more via the Washington Post.

Read more via Cornell University

Ending the HIV Epidemic by 2030? Not Without Steps to Promote Health Equity

An article in the most recent issue of the American Journal of Public Health provides an overview of the Trump Administration’s plan to end the HIV epidemic, and calls for comments from scientists and public health professionals to identify the plan’s strengths and limitations. The take-away? “We are now in an era when the elimination of HIV is a real possibility. But attaining this goal rests not only on science . . . but also on tackling the pervasive and harmful political, social, cultural, and economic barriers that inhibit the success of these prevention tools and the ability to sustain these efforts over time.” There will be no end to the epidemic without health equity.

Related: Congressional spending package meets Trump’s demand to fund national HIV/AIDS prevention efforts, opposes cuts to research and global programs (via the Washington Blade).

Read more via the American Journal of Public Health

Why Experts Say Trump Plan to Lower Drug Costs Won’t Work

Experts predict the Trump Administration plan to lower prescription drug costs by enabling states to legally import brand-name medications from Canada will have little impact. The plan faces opposition from some Canadian lawmakers, who fear the policy will reduce the availability of prescription drugs for Canadian consumers. Moreover, the costs associated with importation, including logistical hurdles and safety protocols, could drive prices back up and cancel out savings. Wall Street analysts also predict the proposal will have little impact on the pharmaceutical industry.

HealthHIV released a statement against drug importation earlier this week to Representatives and other stakeholders.

Read more via Politico.

Read more via the Washington Post

Join Us At SYNC 2020!

SYNChronicity (SYNC) 2020 brings together medical professionals, service providers, government officials, and health advocates to sync effective approaches to address HIV, HCV, STI, and LGBTQ health in the changing and dynamic health care landscape, with a focus on underserved racial/ethnic minorities and LGBTQ communities. The conference is organized by HealthHIV, HealthHCV, and the National Coalition for LGBTQ Health with the guidance of a diverse planning committee. The National Coalition for LGBT Health will hold a member meeting during the conference where you can connect with your colleagues and peers to discuss LGBT Health advocacy! You can register now to attend the conference May 11-12, 2020 at the Grand Hyatt Hotel in Washington, D.C.

ACTION: Register Today!


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