The biggest misconception in the LGBT community about the Affordable Care Act is that many people still don’t realize that subsidies are available to make coverage affordable, according to White House LGBT liaison Gautam Raghavan.
Raghavan was in Dallas Sunday with Kellan Baker and Katie Keith from the group Out2Enroll.
“People are so used to healthcare that is unaffordable,” Raghavan said, although most know they can no longer be denied because of pre-existing conditions and can stay on their parent’s policy until the age of 26.
He said one of the most important policies in the new law is no one can be denied coverage because of their sexual orientation or gender identity.
Just what constitutes discrimination, however, is still being studied.
Fairness Fort Worth President David Mack Henderson brought up the cost of HIV medication on all plans that are available in this area. The best coverage he could find offered a $100 copay for HIV meds. That’s higher than the cost of other expensive drugs.
Raghavan said that was the sort of thing the Department of Health and Human Services is examining to determine if this amounts to discrimination against people with HIV.
Those on HIV medications should make sure the policy they get includes coverage for the medications they’re taking, Henderson said.
Keith said one of the new rights people with insurance now have is the ability to appeal if a claim is denied.
“The appeals process is so important,” she said.
In the past, when a claim was denied, the insurance company didn’t have to reveal whether it was a doctor or a clerk who denied the claim. Now, insurance companies will have to be more transparent.
“Being transgender is no longer a pre-existing condition,” Baker said.
He said in some cases, insurance companies in the past would simply deny coverage to trans people, claiming their entire lives were pre-existing conditions, and they were ineligible for coverage at all.
“The ACA is one of the most important things we’ve done for our community,” Baker said. “Health is a fundamental right.”
The deadline to sign up for insurance is March 31. About half of those who are uninsured can find coverage that includes essential health benefits for under $100 with the available subsidies.
Those who do not have coverage by the deadline will pay a $95 penalty on their taxes next year. That penalty increases in future years. However, those who remain uninsured because Texas did not expand Medicaid and would have qualified for insurance under that program will be exempt from the penalty.
For those who need help, call 800-318-2596. Navigators are working at Parkland and AIDS Arms to help people sign up for coverage.