Health care reform hangs in the balance

By Laurie Young, director of aging and economic security, National Gay and Lesbian Task Force

Laurie Young moderates a recent congressional briefing on LGBT aging.

I had a restless night last night. There has been a lot of talk about health care reform this week with the second anniversary of the historic law’s passage happening last week and oral arguments in the Supreme Court on its constitutionality starting this week. I started thinking about my own health and the insurance that comes with my job and how fortunate I am. I’m fortunate to have good health insurance through my employer. But what if I weren’t employed or didn’t get health insurance from my employer? Many people my age – 62 – have lost their jobs since the beginning of the Great Recession in 2009. The data suggests that people in this age group have a very difficult time trying to find a new job, and thus access to quality, affordable health insurance.

What might happen to an LGBT person who is 62 and can’t find a job? The data shows that many older people who have lost jobs end up collecting Social Security benefits now instead of waiting – mostly because they can’t afford to wait. But collecting Social Security before 66 means receiving only 75% of the benefit that would be received if you could wait four years. The average Social Security benefit is about $14,000 so the penalty for starting at age 62 would be a benefit of $10,500, or about $3,500 less annually than the full benefit. That may not sound like much, but imagine being forced to live with 25% fewer resources? That would mean a substantially lower standard of living for most people.

In this country, unless you are disabled or old enough, health insurance is substantially tied to employment. So imagine the impact of being in your early 60’s, not old enough for Medicare and not getting health insurance from employment. LGBT people, on average, have less money and savings than their straight counterparts,

For many LGBT people, who are less likely to have a partner or spouse to rely on for income and tend to have less in savings than others, unemployment in their late 50’s or early 60’s can lead to tough financial situations and no access to preventive health services.

For people around my age this can be a major problem because this is when many chronic illnesses begin to develop. LGBT people have more health problems to manage because many have avoided health care due to real or perceived discrimination by the very medical professionals who should be helping them. Now, if someone loses a job they might be able to get COBRA benefits, but paying a monthly health insurance premium is a luxury when you’re unemployed and often isn’t feasible for older LGBT adults. Now this should really cause concern for older LGBT adults. But there is change in the works and reason to have hope.

In 2014 when the Affordable Care Act (ACA) is fully implemented people in this situation will have a safety net. In addition to online exchanges in each state to search for the best and most affordable health insurance plan, insurance companies will also be prevented from discriminating against anyone with what was previously called a pre-existing condition. Lifetime benefit limits on health insurance plans will be gone, and those of us with same-sex partners or spouses can even search for plans that cover our entire family. What this means is that there will soon be many more options for unemployed people to get affordable and quality coverage until they qualify for Medicare.

But much of this hangs in the balance and depends on the Supreme Court. Oral arguments for the lawsuits questioning various aspects of health care reform will be held through Wednesday this week.

If part of the law is struck down by the Supreme Court when they rule on the law in June, then many of these nightmare scenarios will continue to persist and we’ll be a long way off from a solution.