Category

LGBT

FAQ: Five Frequently Asked Questions About the Health Care Rights Law and Proposed Changes

By | FACT SHEET, Health Care, Health Care Defense, LGBT, REPORTS

The Trump Administration has published a proposed rule to eliminate key nondiscrimination protections under the Health Care Rights Law (Section 1557 of the Affordable Care Act) for LGBTQ seniors, people with limited English proficiency and others in health care settings. If finalized, this rule change would increase the likelihood that older adults would experience discrimination in accessing health care and make it harder for them to seek redress in the face of that discrimination.

This FAQ, “Five Frequently Asked Questions about the Health Care Rights Law and Proposed Changes,” outlines the changes including attempting to eliminate the rights of LGBTQ seniors, rolling back protections for limited English proficient (LEP) older adults, and limiting the way that victims of any type of discrimination can seek redress under the law.

Justice in Aging’s Statement on Trump Administration’s Proposed Roll-back of Health Care Rights

By | Affordable Care Act, Health Care, LGBT, Safety Net Defense

Today as part of an ongoing attack on the most marginalized, the Trump Administration is proposing dangerous and far reaching changes to regulations implementing the Health Care Rights Law, Section 1557 of the Affordable Care Act, which prohibits discrimination in healthcare. The proposal attempts to eliminate the rights of LGBTQ people. It also rolls back protections for limited English proficient (LEP) older adults, and attempts to radically limit the way that victims of any type of discrimination can seek redress under the law. By gutting the only federal law designed to protect against discrimination in health care, the move is a cruel, extremist, and transparent political attack on LGBTQ older adults, LEP seniors, and others who frequently face discrimination in accessing care.

The ACA’s Health Care Rights provision is a landmark civil rights law that prohibits discrimination on the basis of race, color, national origin, sex, age, and disability in federal health programs and activities. The law includes affirmative protections for consumers and obligations on insurers and providers, as well as a new avenue for older adults and others to enforce their rights.

The proposed changes to the Health Care Rights Law will be particularly harmful for transgender older adults – one in five of whom report being refused care because of their gender status. This discrimination, which compounds over a lifetime, contributes to poorer health outcomes among transgender older adults, with one in three reporting poor physical health. By deleting references to protections based on gender identity, sexual orientation, and sex stereotyping across federal healthcare regulations, the Trump Administration’s proposal is saying transgender older adults and LGBTQ people more broadly do not have the right to receive the care they need and be treated with dignity.

In the same proposed rulemaking, the Trump Administration is also rolling back language access protections for LEP older adults by eliminating the requirement that healthcare providers affirmatively distribute notices of non-discrimination and include translated taglines in significant communications to consumers. These requirements, key to enforcing Title VI of the Civil Rights Act, are critical to assist LEP communities to better understand their rights and access care.

Finally, if gutting key provisions of the existing regulations were not enough, the proposed rulemaking takes aim at the Health Care Rights Law’s enforcement structure, which would make it significantly more difficult to bring particular discrimination claims under the law.

To be clear, this proposed rule is part of a larger, strategic attack on the lives of LGBTQ and LEP older adults. The Department of Health and Human Services Office for Civil Rights (OCR), the same agency tasked with enforcing Section 1557, recently released a final “Conscience Rights” rule that allows providers to discriminate against transgender older adults and others on religious and moral grounds and changed the OCR mission statement to emphasize conscience and religious freedom. Meanwhile, the Department of Homeland Security’s proposed “public charge” rule would make it nearly impossible for LEP older immigrants to enter the U.S. or become permanent residents if they are not wealthy and use or might need Medicaid or help paying for Medicare, food or housing.

Upon the proposed rule being published in the Federal Register, a 60-day public comment period will begin. In the coming weeks, Justice in Aging will provide resources, including template comments, to help advocates fight back. Now is the time to tell the Trump Administration that the lives, rights, and dignity of LGBTQ older adults, LEP seniors, and people with disabilities matter and to protect the Health Care Rights Law.

Aging as LGBT: Two Stories

By | BLOG, Health Equity, LGBT, SENIOR POVERTY

Tina and Jackie were born in the same town in 1947. Despite similar beginnings, their lives take very different turns. In 1967, Tina meets Frank. And Jackie meets Frances. As a same-sex couple, Jackie and Frances couldn’t marry, were denied spousal benefits, and experienced a lifetime of discrimination and lost wages. Fast forward to today, and Jackie, like so many other older adults, struggles with financial insecurity, social isolation, and overall lack of health and well-being, simply because they are lesbian, gay, bisexual, or transgender (LGBT). Read More

New Fact Sheet: New Guidance on Spousal & Survival Benefits for Married LGBT Individuals

By | FACT SHEET, LGBT, REPORTS, Social Security

On March 1, 2017 the Social Security Administration (SSA) announced that it would reopen its decisions to deny spousal or survivor’s benefits to individuals who had been married to someone of the same sex, and whose marriage wasn’t recognized because of a discriminatory state or federal ban on marriage.

This ruling and policy applies not only to individuals who were denied benefits after the Supreme Court struck down federal discrimination against same-sex spouses (in United States v. Windsor in 2013) and state discrimination (in Obergefell v. Hodges in 2015), but also to individuals who applied for and did not receive benefits before these Supreme Court decisions because of the discriminatory laws in effect at the time they applied.

A new Fact Sheet on this guidance includes more detailed information about who is affected by the new guidance, who isn’t, and what advocates and their clients should do to get their cases reopened.

This fact sheet was authored in collaboration with our partners at SAGE, Lambda Legal, and the National Committee to Preserve Social Security and Medicare.

New Medicare Fact Sheets for LGBTQ People

By | BLOG, Health Care, Health Disparities, HOMEPAGE, LGBT, Medicaid, Medicare
Ever since the Supreme Court first overturned the federal Defense of Marriage Act in 2013 and then, in 2015, making same-sex marriage legal in every state, there has been a flood of changes in how government programs address the needs of LGBT individuals. For people who qualify for Medicare, there are many important changes:

  • Married same sex couples now have coverage for Medicare and Medicaid under the same rules as opposite-sex married couples.
  • Transgender individuals have protection from discriminatory treatment in health care.

Read More

July 5: Immediate Changes to Medicaid Managed Care

By | BLOG, Health Care, HOMEPAGE, Language Access, LGBT, Long Term Care, Medicaid
On July 5, the first wave of new Medicaid managed care regulation requirements go into effect. The Centers for Medicare and Medicaid Services (CMS) published the final Medicaid managed care rule this spring, introducing sweeping changes to how the federal government will regulate the entities that manage long-term services and supports (LTSS). While many of regulation’s big ticket items will be implemented over the course of the year, a few important pieces go live this summer. Justice in Aging will discuss these changes in a free webinar on June 30. Here’s a short list of some of the items we’ll be discussing. Read More

New Regulation Prohibits Discrimination in Health Care: Key Highlights for Aging Advocates

By | Affordable Care Act, BLOG, Health Care, Health Disparities, HOMEPAGE, Language Access, LGBT
Aging advocates working to promote health equity got some good news and extensive summer reading last week. After much anticipation, the U.S. Department of Health and Human Services (HHS) released final regulations that seek to transform care for underserved communities by ending discrimination in health care services and settings. Read More

Big Win For Married LGBT SSI Recipients

By | BLOG, HOMEPAGE, LGBT, LITIGATION, Supplemental Security Income
The last few weeks have brought some good news regarding Held v. Colvin, a case we (along with Foley Hoag LLP and GLBTQ Legal Advocates & Defenders, or GLAD) filed in March 2015 against the Social Security Administration (SSA) on behalf of Plaintiffs Hugh Held and Kelley Richardson-Wright and a proposed nationwide class.

We filed this case to stop SSA from attempting to collect “overpayments” from very low income people over 65 and people with disabilities receiving SSI who had been married to someone of the same sex on or before June 2013 when the Supreme Court struck down the Defense of Marriage Act (DOMA). Read More

Advancing Health Equity for Older Adults

By | Affordable Care Act, BLOG, Health Care, Health Disparities, HOMEPAGE, Language Access, LGBT, Medicaid, Medicare, Nursing Homes
When John’s partner, Jack, moved into a nursing facility, the staff, who were uncomfortable assisting a gay man, let 16 days pass before helping him take a shower. “He was finally taken in for a shower by a staff member with empathy,” John shared. Afraid of future neglect and discrimination, John began checking Jack out of the nursing facility and bringing him home to their apartment to help Jack shower and shave.

John should not have to worry about a nursing facility neglecting Jack due to his sexual orientation. As an 83 year-old caregiver, John should not face the additional burden of replacing Jack’s neglected care. Read More