What Trans Individuals Need To Know About Their Rights Under Obamacare
Last weekend, I felt a tiny glimmer of hope in light of the looming threat of the Trump Administration and Republican-controlled House of Representatives. Trump’s new health care bill (aka the American Health Care Act, aka Trumpcare, aka the sound you make when you sneeze while congested), didn’t receive the necessary amount of votes to pass through the house and become law.
And thank god for that, as most humans with souls noted that the AHCA was nothing more than a tax break for millionaires and a certain loss of health care for 24 million people. The new health care bill would also have been a minefield for women, as it vowed to defund Planned Parenthood, which is less the “abortion factory” right-wingers claim it is than a vital center for reproductive health.
But rather than focus on the horrors we avoided, I instead want to discuss the services that were preserved for marginalized people under Obamacare/ACA (the Affordable Care Act), and how those programs should be readily taken advantage of now, before another possible villain comes along and tries to take them away. Specifically, it seems not everyone is aware of the opportunities Obamacare offers in terms of transgender health.
Of course, Obamacare is nowhere near perfect. This plan doesn’t make it easy for trans individuals to receive coverage for gender reassignment or hormone therapy, for example. But the ACA does open doors that were previously shut.
For example, Gender Identity Disorder/Gender Dysphoria was once considered a pre-existing condition under the terms of many insurance companies, and therefore would not be covered if a person was interested in hormone therapy or gender reassignment surgery. But, after Obamacare was implemented, insurance companies can no longer refuse to cover such individuals. The Nondiscrimination in Health Programs and Activities Proposed Rule—Section 1557 of the Affordable Care Act—was created to “assist some of the populations that have been most vulnerable to discrimination and will help provide those populations equal access to health care and health coverage” and specifically states that “sex-specific health care cannot be denied or limited just because the person seeking such services identifies as belonging to another gender.” This means that a doctor can’t deny a patient a hysterectomy or treatment for ovarian cancer, for example, just because they may identify as male.
Physical surgeries and treatments are not the only things on the minds of trans individuals, however, seeing how the rates of substance abuse amongt LGBT youth is 20-30 percent, whereas the rate for the general population is only 9 percent. It’s worth noting that substance abuse, in turn, is linked to youth violence, which could potentially contribute to the fact that 13-15 percent of LGBT juveniles in the US are incarcerated, according to a 2012 survey. Without access to mental health professionals who can help ward off the anxiety that comes from being a part of such a deprecated group of people—and particularly for trans youth, who potentially face more physical violence and bullying than others— that statistic would surely increase over time. The ability to express fears and worries during hormone therapy or sex reassignment surgery to a professional is an important part of that process.
Fortunately, the Mental Health Parity and Addiction Equity Act (MHPAEA) was implemented under Obamacare in 2008. This Act essentially states that health insurers can’t offer more benefits for physical/surgical medical coverage than they do for mental health coverage, which opened so many doors for people who otherwise couldn’t afford help.
While the death of AHCA is certainly something to celebrate, it’s also a foreboding warning for what may come in the future. While the bill didn’t pass, it’s important to remember that there were still representatives and U.S. citizens alike who praised and planned to vote for it. We have to keep fighting—for our right to health care as well as all others: If you’re only able to express a tirade of frustration on Twitter from the safety of your home, do so. Try to join Women’s Marches, or local protests; call or email your state representatives. Even if you are not a member of the LGBT community, you can still help if you’re an ally. If you’re a woman, a person of color, if you’re disabled, or if you simply believe humans are human and deserve to be treated as such, we’re all on the same team, fighting this same boss battle.
Take charge of your life and your future, not to mention the futures of others behind you and before you who might not be able to and could not previously act. Use your voice. Push up your sleeves, take a deep breath, and scream.
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