As promised, today we will look at the positive aspects of the new health care law (Obamacare) as it relates to transsexuals in particular, and in some cases to the transgender community in general.
1) The new law unequivocally prohibits discrimination by health care providers and insurers against transgender identified people. That is a tremendous victory. Still, we have to be sober-minded and remember the war isn’t over. As a supportive hospital administrator recently remarked at a health care conference I attended, policy does not always equate with performance. It will take a while for doctors and staff to be trained in the practical application of the law. Procedures may need to be worked out for questions such as, will a man or woman share your semi-private room. So there will be pockets of ignorance, especially in the beginning.
There will also be pockets of resistance. I can give you an example from personal experience in a different area: fair housing.
A quick overview: the Civil Rights Act of 1866 prohibited housing discrimination. However, the law had no teeth. No federal enforcement provisions have been provided. (Note: I have not heard anything about how anti-discrimination against transsexuals will be enforced.) Title VIII of the Civil Rights of 1968 (over 100 years later!) took care of that oversight, as well as expanding the scope of the law.
Back in the early 1980’s, I served as the Section 8 Housing Director for a local housing authority. I oversaw the part of Section 8 that dealt with low income families and individuals in private residences who were seeking or receiving rent subsidies. I found out about a vacant apartment with a landlord willing to accept Section 8. I referred the next family on my list to the landlord. They were black. They were told that it had already been rented. A few days later, a white woman looking for Section 8 assistance came into my office and told me that she had found an apartment. It was the same apartment that the black couple had been turned away from. I referred the case to the county’s Human Rights Commission and some measure of success was achieved. But the point is, this was nearly 15 years after the Fair Housing Act was passed.
Yes, we now have solid grounds to fight against discrimination and appeal decisions that are discriminatory against transsexuals. Just remember that some of those fights will occur when we are vulnerable due to serious health issues, and we have either been refused timely health care, or we have been denied insurance coverage and will need to deal with a stack of bills, calls from bill collectors and the like until hopefully the issues is finally resolved in our favor. Make no mistake. I am as thrilled as anyone about the anti-discrimination provision. But, having been through the wars, I have to be realistic.
2) Affordable health insurance for low-income individuals and families: Some of us, perhaps connected to some of the issues related to our transsexualism, find ourselves in low income situations, but not so low that we currently qualify for Medicaid. Therefore, we find ourselves unable to afford health insurance. Our employers do not provide it or we are self-employed. Now we have coverage for at least some of the medical bills we have been paying out of pocket.
3) Coverage for pre-existing conditions: This is especially important for those of us who were paying out of pocket. Now that we will be getting insurance, we will be bringing pre-existing conditions to the table. They can’t be excluded from coverage.
For our final post on this topic, we will look at some possible negative concerns of Obamacare as it relates to the transgender community.