New ruling makes services more accessible for minorities, LGBT
While Obamacare has made medical coverage more affordable for millions of Americans, it has not necessarily made it equal. Vulnerable populations, such as minority and LGBTQ communities, continue to experience higher rates of discrimination in the health care system.
That prompted the Department of Health and Human Services to release a new nondiscrimination ruling in May aimed at ensuring at-risk groups receive equal access to health care and health coverage through Affordable Care Act marketplaces and other health programs funded by HHS.
Discrimination on the basis of race, color, national origin, sex, age or disability has always been illegal under the Affordable Care Act, but this new ruling is drilling down on just what constitutes bias under these tenets.
For example, gender identity discrimination is prohibited as a form of sex discrimination; health care providers cannot deny sex-specific health care based on the fact that the person requesting them identifies as another gender.
It also stipulates that women receive equal access to health care and insurance.
Similarly, HHS is trying to eliminate discrimination against those for whom English is not a first language by requiring medical providers supply access to free and accurate language assistance services in a timely manner.
And it outlines similar requirements to prevent discrimination on the basis of disability.
“One of the key tenets of the Affordable Care Act is that plans cannot discriminate, and there’s been a lot of work to really flesh out what that means,” says Eric Gascho, vice president of government affairs for the National Health Council.
“What they are really focusing on is looking at minorities and the LGBTQ community, populations that were often discriminated against pre-ACA, (which) now have a lot more protections.”
Uninsured rates tend to be higher among minority groups, which also tend to see higher rates of chronic medical conditions such as diabetes, heart disease and breast cancer — especially among African-Americans and Hispanics.
Major health concerns like HIV/ AIDS, mental illness, substance abuse and sexual and physical violence tend to be higher among LGBT communities.
The insurance rates for at-risk populations have steadily been on the rise since the Affordable Care Act went into effect in 2010, but over half of the country’s uninsured population is still made up of people of color, according to the Kaiser Family Foundation, which reports the uninsured rates for blacks is 17.2% and 12.2% for Hispanics, compared to 8.1% in white, non-Hispanic communities.
In addition to making health care more equitable, federal and state governments, under the Affordable Care Act, are also working to make it more accessible, says Karen Pollitz, a senior fellow at the Kaiser Family Foundation.
“There’s been an effort, particularly in New York State, to sign up in-person assisters who have close ties to these communities and who can target populations who may be vulnerable, who may have very high uninsured rates, who may have language barriers and so may need additional assistance,” she says.
“One of the goals of the In Person Assistance Programs (is to) really ramp up outreach in the most impacted communities and get the word to them about coverage and financial assistance.”