Seven More Things You Should Know About the Affordable Care Act

By Arielle P. Schwartz, Holley Law Fellow, National Gay and Lesbian Task Force

There are many reasons why lesbian, gay, bisexual and transgender (LGBT) communities should be enthusiastic about the benefits of the Affordable Care Act (ACA). The Task Force’s Meghan Maury laid out five of those benefits in a recent blog post.

Here are seven more benefits we think you should know:

1. It’s not too late to sign up for Health Insurance coverage. If you sign up by January 15, you can have health insurance coverage start on February 1. Open enrollment for the 2014 year continues until March 31 – so check out your options at healthcare.gov!
2. The ACA offers affordable private health policies for same-sex couples who cannot enroll in their partner’s employer-based plan.[1]
3. The nondiscrimination section of the ACA creates a private right of action for people facing discrimination on prohibited factors by incorporating by reference civil rights statutes such as Title VI of the Civil Rights Act of 1964. That means you can file a legal claim if you are discriminated against by any medical provider or insurance company because of your sexual orientation or gender identity. You can file your complaint with the federal government here.
   • In fact, the federal government has already started to enforce the law and ensure that transgender people are protected from discrimination. In an announcement last month, the Department of Health and Human Services Office of Civil Rights (OCR) announced “OCR recently provided technical assistance to a health clinic on appropriate treatment of transgender individuals after concerns were raised in the process of a privacy-related complaint. OCR is committed to the enforcement of Section 1557, including the prohibition on sex discrimination in covered health programs and activities.  The law was effective upon enactment and OCR has been accepting and investigating complaints under this authority.”
4. If you were uninsured and did not purchase an individual health insurance plan before January 1, a tax penalty will be applied to your annual taxable income each month thereafter. However, this year the government is giving you a grace period, so if you purchase a plan by March 31, 2014, you won’t be penalized on your tax return.
5. Historically, LGBT communities are disproportionately affected by federal and state definitions of family that are designed to exclude LGBT families. However, there is no universal definition of family under the ACA, meaning diverse family structures are recognized.[2]
6. The ACA includes protections based on gender identity and sexual orientation. You cannot be charged a higher premium based on gender identity or sexual orientation.
7. If you identify as transgender, your insurance plan should cover the services you need as long as those same services are covered for gender-conforming individuals. When you are shopping for plans through the marketplace, compare plans side-by-side and look for the “exclusions” and “limitations” on coverage.[3]  In addition, health plans offered through state marketplaces are expected to cover some transition-related care, such as hormone replacement therapy and gender-specific care.

The ACA aims to provide accessible and affordable healthcare. If your New Year’s resolution was to get insured and you missed the deadline to purchase coverage under the federal healthcare exchange, do not fret. Enroll by January 15, 2014 and your insurance will start February 1, 2014. To learn more about how the ACA affects LGBT communities, be sure to check out the website Out 2 Enroll, which is run by a coalition of organizations dedicated to making sure affordable healthcare is accessible to you. Additionally, Strong Families has provided a healthcare guide, which suggests a list of questions to ask your healthcare provider so you know the benefits available to you.

The National Gay and Lesbian Task Force is committed to providing you with updates on how this new law impacts the lives of LGBT people and as a result, continues to move our communities forward.