Archive for the ‘Health Care’ Category

Today, President Barack Obama stated in a televised interview that he believes that same-sex marriage should be legal:

“At a certain point, I’ve just concluded that for me personally it is important for me to go ahead and affirm that I think same-sex couples should be able to get married,” Mr. Obama told ABC News in an interview that came after the president faced mounting pressure to clarify his position.

This is a historic moment – it is the first time that a sitting U.S. president has stated a position in favor of marriage equality.

So how does this affect the lived reality of LGBTQ Latin@s? Well not too much, yet. Though this affirmation does not have any legal effect just yet – neither the Supreme Court nor Congress seem in a rush to overturn DOMA – this “evolving” of the president’s position does indicate the increasing visibility of LGBT advocacy in the last few years, and places the President in a position to do something about making that change.

When same-sex marriage does become a reality at a national level, there will surely be benefits for LGBTQ Latin@ communities. For one, LGBTQ immigrants with U.S.-citizen partners will have the option to be petitioned for permanent residency and citizenship, in the same way that straight people are able to do currently. This would be huge for the vast number of bi-national couples who face separation or having to leave the U.S. to be together. The Uniting America Families Act – a proposed measure that would allow U.S. citizens to petition same-sex partners for citizenship – also addresses this issue for bi-national same-sex couples and has been part of NLIRH’s policy priorities, but federal marriage equality would solve this issue altogether.

Although this is a step in the right direction, legalizing same-sex marriage does not even begin to scratch the surface of the social justice issues that LGBTQ Latin@s face today. LGBTQ immigrants face numerous barriers that marriage simply does not touch, and strategies that require immigrants to couple with U.S.-nationals for citizenship will only affect a small portion of the LGBTQ immigrant community. And though legalizing same-sex marriage may mean that some LGBTQ Latin@s will be able to share their partners’ health benefits, it will not create health benefits for couples in which neither party is insured. We envision a world in which everyone has access to care and in which everyone has the right to live and work in the communities they choose, regardless of marital status. Marriage equality will create these conditions for some, but will leave many LGBTQ Latin@s with these problems unresolved.

It is a good day for LGBTQ people today, but we must not envision marriage equality as the end. Only an end to inequity can bring reproductive justice for all!

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For day 3 of the Health Equity Can’t Wait! blog carnival, we’ve teamed up with the National Gay and Lesbian Task Force to write about LGBTQ and Latin@ health, making clear the importance of an intersectional analysis and advocacy:

We will never fully understand the struggle of someone trying to access an abortion if we do not also know how being a transgender man of color has affected his experience. We cannot know an immigrant’s struggle to access culturally competent and affordable health care if we do not think about how being queer has affected where she feels safe. If we do not look at the intersections, we paint an incomplete picture and we fail to see the very real ways that multiple marginalized identities play out in people’s lives.

Check out the whole piece over at the Task Force blog!

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NLIRH Rally for Health!

March 27, 2012

Supreme Court of the United States

On Tuesday, March 27, the National Latina Institute for Reproductive Health (NLIRH) along with our poderosa activists from NYC rallied at the Supreme Court of the United States to stand for health care!

On March 26, 27 and 28, the Supreme Court heard arguments regarding the constitutionality of the law’s major provisions. And poderosa activists were there chanting “Yo! Quiero! Obamacare!” to show their support for the law that has the potential to increase meaningful access to quality and affordable health care for millions of Latinas and their families.

Check out the below video taken by Kara Ryan at National Council of La Raza (NCLR) about what health reform means for Latinas.  Kara, who is a  Senior Research Analyst with NCLR’s Health Policy Project, also reflect on her favorite day of the Supreme Court arguments in her blog post here.

20 Days of ACA Blog Series

March, 2012

NLIRH Blog, Nuestra Vida, Nuestra Voz

Throughout March, we brought you the blog series, 20 Days of ACA: Lifting Latina Voices for Health Reform.  Each post focused on one provision of the health reform law, or Affordable Care Act, and how that provision has and will benefit Latinas and their families. Each post also featured a photo of one of our supporters and activists sharing their reasons for supporting health reform.

Here is a re-cap of our posts:

ACA Second Anniversary

March 23, 2012

And last but not least, just a few days before the Supreme Court began its review of the Affordable Care Act, the historic legislation celebrated its second birthday. On March 23, 2010, President Barack Obama signed the health reform bill into law.

And NLIRH celebrated by releasing a press statement and joining 180 other local, state, and national health equity and civil rights advocates in thanking the Obama Administration for their continuing dedication to health equity and in celebrating what the health reform law does to reduce racial and ethnic health disparities.

And finally, our fabulous Executive Director, Jessica Gonzalez-Rojas shared her reflections in the piece, The Affordable Care Act: Hope for Health Care Equality for All in RH Reality Check.

NLIRH will continue to advocate for the law’s funding and implementation, so be sure to stay tuned for more information and ways to take action to support the ACA!

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Throughout 20 Days of ACA, we have discussed many of the preventive health services that will be covered by private health insurance companies with no additional cost, or “co-pay” to patients.

The final health service we will discuss is one that NLIRH has been talking about all along: contraception.

Here is a timeline of the Department of Health and Human Services’ (HHS) decision to affirm what we all have known: contraception is prevention.

  • December 3, 2009: The Women’s Health Amendment (WHA) passes the U.S. Senate and becomes part of health reform. The WHA requires insurance companies to cover women’s preventive health services with no additional costs (like co-pays, co-insurance or deductibles). The list of preventive health services is to be developed by the Institute of Medicine.
  • July 19, 2011: The Institute of Medicine (IOM), a non-partisan panel of health professionals, determines that contraception is prevention and should be given the same consideration as other preventive health services that will be covered without co-pay. NLIRH applauds the decision.
  • August 1, 2011: The Department of Health and Human Services takes up the recommendation of the IOM and includes contraception in the list of preventive services. Houses of worship are exempt, but HHS begins to receive comments from the public on how the rule will apply to religiously-affiliated employers.
  • January 20, 2012: HHS announces that religiously-affiliated employers, like Catholic universities and hospitals, must comply with the contraceptive coverage rules, but have an additional year (until August 1, 2013) to comply.
  • January 20-February 10, 2012: NLIRH launches “I Heart BC” campaign, consisting of Twitter and Facebook actions, policy advocacy, media commentary, and the release of Just the Fact: Latinas and Birth Control and Sólo los hechos: las Latinas y la cobertura de los anticonceptivos to educate policymakers and the media on Latinas’ support and need for greater access to birth control, regardless of employers’ religious affiliations.
  • February 10, 2012: The Obama Administration announced an accommodation to the rules: employees at religiously-affiliated institutions can gain full coverage for contraception directly from insurance companies. NLIRH applauded the commitment to expanding access to contraception.

However, discriminatory attacks on this important coverage have not stopped. The Blunt Amendment, which would have given employers the power to deny coverage for any type of health service that goes in contrast to any religious OR moral views of the employer, was only barely defeated in the U.S. Senate. Senator Marco Rubio (R-FL) introduced a bill that would allow employers to deny contraceptive coverage for their employees. And we did not think it could happen, but it did: Arizona introduced a law that would protect employers who fire employees who use contraception to avoid pregnancy.

NLIRH will continue to engage Latinas across the country to fight discriminatory attacks against women and Latinas’ health.

Why is this coverage important to Latinas?

According to Hart Research Associates, more than half of Latinas ages 18 to 34 report that the cost of prescription birth control has inhibited their ability to use it consistently.

Thanks to the ACA, this barrier will no longer exist for Latinas with health insurance. And looking to 2014, when health insurance plans will be available on the Affordable Insurance “Exchanges”  and employers who do not provide health insurance to employees will face penalties, more Latinas will be covered by health insurance and have great access to this great benefit!

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Throughout 20 Days of ACA, we have discussed many ways the Affordable Care Act (ACA, or health reform) prioritizes the prevention of disease and illness. We have discussed the creation of the National Prevention Council and National Prevention Strategy as well as no co-pays for a wide range preventive care services including cervical cancer screening, pregnancy-related care, STI/HIV testing, and maternity and newborn coverage in the state insurance “exchanges.”

Today, we discuss another preventive health service that will be offered with no co-pay: domestic violence screening.

Starting on August 1, 2012 new health insurance plans must begin to cover this important service at no additional cost to patients. This important provision was included thanks to the Women’s Health Amendment (WHA).

How does domestic violence or inter-partner violence (IPV) impact Latinas?

According to year 2000 estimates, nearly 1 in 4 (23.4%) Latinas face domestic violence over the course of their lifetime. This violence comes in many forms including but not limited to verbal abuse, physical assault, and sexual assault. Abusive partners also cut off access to support systems and money (even partners’ earned wages.) Increasingly,  reproductive coercion – including sabotaging birth control methods, threatening to leave a women if she does not become pregnant, forcing contraception or abortion, and forcing partners to use recreational drugs to enhance arousal - is being used a form of violence against partners.

And while more data is needed, we know that immigrant Latinas are  overrepresented among IVP-related homicide victims and they face more barriers to leaving abusers due to lesser developed support systems, ineligibility for public benefits, and limited English proficiency among others. We also know a pregnant woman has a 35% increased chance of experiencing IPV compared to non-pregnant women and that IPV in LGBTQ communities occurs, but is often ignored.

To add to the challenges, states like Arizona and Alabama have enacted a series of dangerous immigration policies that only  decrease Latinas’ confidence in law enforcement, break apart families through incarceration, detention and deportation, and create an “anti-immigrant” culture.  Despite the creation of the U-Visa in 2000 to protect immigrants who assist law enforcement, these egregious state immigration policies threaten public safety and health by making it more difficult for Latina immigrants of IPV to leave their abusers.

Why is no co-pay for domestic violence screening and counseling important for Latinas?

Much needs to be done in this country to end domestic violence, address domestic violence in LGBTQ communities, and elevate the status of those who identify as women. For starters, NLIRH called for comprehensive immigration reform and condemned Arizona-like immigration policies.

The Affordable Care Act make a small but necessary contribution to the health of women who face domestic violence. By requiring no co-pays for domestic violence screening, the health care law removes a barrier for women whose wages and access to money have been cut off by abusers.

Health reform recognizes that women face unique barriers to health care that men do not face. From no co-pays for women’s-specific preventive care to non-discrimination protection, the ACA hopes to reduce health disparities faced by women, and particularly women of color by improving women’s access to health care insurance and public health services. And as Latinas have disproportionately been excluded from health services, they stand poised to gain from the reforms under the ACA.

There are only a few more posts in 20 Days of ACA — stay tuned throughout this week!

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We have talked a lot about health equity in 20 Days of ACA as achieving health equity is important for Latinas’ health.  Latin@s have the highest rates of health uninsurance and suffer from a number of diseases and conditions at higher rates than other racial/ethnic groups.

So, today we would like to cover some of the other awesome things the Department of Health and Human Services (HHS) is doing to promote health equity and reduce health disparities faced by communities of color and other underserved populations.

  • Health reform established the Offices of Minority Health (OMH) at six agencies within the Department of Health and Human Services (HHS) including the Food and Drug Administration (FDA), Centers for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA.) The goal of these offices is to better “lead and coordinate activities that improve the health of racial and ethnic minority populations and eliminate health disparities.”
  • The ACA also creates Offices of Women’s Health (OWH) at federal agencies including the Center for Disease Control and Prevention (CDC) and creates a federal committee to coordinate work and information.

HHS has also crafted a number of strategic plans that together mark the nation’s first coordinated roadmap to reducing racial and ethnic health disparities. These plans are:

  • The HHS Action Plan to Reduce Racial and Ethnic Health Disparities develops specific goals and strategies for the years 2010-2015 to advance the vision of a “nation free of disparities in health and health care” and “improve the health of vulnerable populations across the lifespan.” The Action Plan details specific actions federal agencies will take to achieve five major goals for reducing health disparities. You can read the report in its entirety here.
  • The National Stakeholder Strategy for Achieving Health Equity is a product of the National Partnership for Action to End Health Disparities (NPA) and “provides an overarching roadmaps for eliminating health disparities through cooperative and strategic actions.” Utilizing a ‘bottom-up’ approach by engaging individuals who work locally and nationally to improve health equity, the goals of the NPA and National Stakeholder Strategy were defined. The five goals are (1) increasing awareness of health disparities, (2) strengthening leadership for addressing disparities, (3) improving health outcomes for underserved communities, (4) improving cultural and linguistic competency in health care and (5) improving data coordination and utilization.  The entire report is here.
  • While Healthy People 2020 was not part of health reform, the national wellness and health promotion plan will work in concert with other HHS plans to reduce health disparities.  Healthy People has been ‘producing a framework for public health prevention priorities and actions” for the past thirty years. However Healthy People 2020 is unique in that it developed with much participation from local and community health advocates and includes new initiatives including Adolescent Health, LGBT Health, and Social Determinants. One of the four stated goals of the 2020 plans is to “achieve health equity, eliminate disparities, and improve the health of all groups.” Information on Healthy People 2020 is available here.

Why are these plans and strategies important for Latina reproductive health and justice?

We know that health equity advocates in communities across the country are doing great work to promote health, wellness and increase access to care for communities of color. However, achieving health equity is a long-term goal which involves overcoming a number of political, economic and social challenges. The federal government, with the power of the purse, can make substantial investments in local, state and national initiatives to end health disparities. And while politics will always play a role in affairs of the federal government, federal initiatives can help elevate the importance of health equity and educate policy makers on the importance of substantial and sustainable investments in the health of underserved communities.

Additionally, many of the above-listed strategies were developed with substantial  input and buy-in from individuals who work with underserved communities to promote health, wellness and increase access to health care.

We know that Latinas, as a diverse group, can face multiple oppressions in our health care system. Federal strategies to highlight and address sources of inequities will not only improve Latinas’ health outcomes, but also advance social justice, dignity and the promise of equal opportunity for Latinas, their families and their communities.

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Throughout 20 Days of ACA, we have discusses how the Affordable Care Act (ACA) or health reform will address inequities in health care and health faced by people of color and other underserved communities. We have talked about improving the health care workforce, increasing access to preventive care, and Community Transformation Grants to address chronic diseases in communities marginalized by the health care system.

Today, we will discuss another effort headed up by the Department of Health and Human Services (HHS): improving data collection on undeserved communities so as to better understand and address health disparities.

Why is improved data collection important?

Health data collected from federal agencies, department and offices is used to inform national, state and local health initiatives. Without detailed demographic information, health initiatives may overlook the health care challenges of specific underserved populations. This particularly true for LGBTQ Latin@s, whose intersectional identities and challenges are not well understood.

As highlighted in a report from the Joint Center for Political and Economic Studies, improved data collection is necessary not only for health equity initiatives, but also to ensure nondiscrimination in health care,  to ensure adherence to civil rights law, elevate the importance of health equity in public policy, and understand the health care needs of diverse immigrant populations.

What does the ACA do to improve data collection?

The Affordable Care Act requires enhanced data collection on race, ethnicity, sex, primary language, disability status and for underserved rural populations with the explicit goal of reducing health disparities. Additionally, HHS has proposed new data standards on sexual orientation and gender identity so to better understand the challenges and opportunities for improving the health of lesbian, gay, bisexual, transgender, and queer individuals.

Starting in 2013, all federally-funded health programs and population surveys, including the Medicaid and CHIP programs must collect data on the above-listed characteristics, and others deemed important by HHS. Under the health reform law, the Secretary of HHS leads efforts to analyze and disseminate data collected. And again, the ACA makes very clear that these new standards serve the purpose of reducing health disparities.

Knowledge is power. With greater understanding of the health care needs of Latinas and other the other intersecting identities Latinas identify with, community, state and national health initiatives can be developed or better tailored to the address the multiple oppressions experienced by Latinas in our health care system and improve health equity.

For more information about HHS’s developing standards for sexual orientation and gender identity, visit the health reform site here.
Stay tuned all this week for more in 20 Days of ACA!

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It’s LGBT health awareness week, and today we’d like to spend some time talking about a few of the ways the Affordable Care Act will affect LGBTQ Latin@s. Shall we?

Medicaid expansion: We’ve already talked about this some before, but it’s important to mention here that the ACA will expand Medicaid eligibility dramatically, and will cover U.S. citizens and eligible immigrants up to 133% of the federal poverty line. This is absolutely crucial to LGBTQ Latin@s. People of color are disproportionately poor, and most available data suggests that LGBTQ folks are disproportionately poor as well. The data that we have that looks at both, such as the data from the Latin@ subset of the Trans Discrimination Survey, suggest extreme levels of poverty. What this means is that LGBTQ Latin@s and people of color stand to benefit greatly from a Medicaid expansion, and that it will bring health care to many LGBTQ folks that did not have it before. Not included in this expansion, unfortunately, are undocumented immigrants and legal permanent residents who have had that status for less than five years, many of whom are undoubtedly LGBTQ-identified. We’ve gotta keep fighting the good fight to get these folks covered.

Data Collection: One of the provisions of the Affordable Care Act is geared toward improving data collection, and we were incredibly pleased to see that last year, Health and Human Services Secretary Kathleen Sebelius announced a plan to expand data collection on Lesbian, Gay, Bisexual, and Transgender populations. The plan calls for the integration of sexual orientation and  gender identity questions into national health data collection surveys, and will not only bring to light important issues on LGBT health and health disparities, but having these numbers also will facilitate the funding needed to create and implement relevant public health interventions.

The end of pre-existing conditions exclusions: Again, this is something we’ve already talked about, but it is worth mentioning again here. This obviously applies to any LGBTQ-identified person who may be diabetic, has had a c-section, or any number of common health issues (i.e. lots of people), but this is especially important for transgender Latin@s. Under many private plans, simply being transgender is a “pre-existing condition” and reason for exclusion. This means that folks could get denied insurance on these grounds, or that if they were insured that any ongoing care relating to gender re-alignment (including every day care such as hormones) would not be covered. This is clearly unacceptable, and we’re really glad to see it go.

We were also excited to hear that the exchanges may not discriminate on the basis of sexual orientation and gender identity in their activities, and insurance plans offered within them must include a list of essential health benefits including preventive and mental health services.

Stay tuned for more on how our communities stand to benefit from the Affordable Care act in 20 Days of ACA!

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Over 30% of all Latinos are uninsured for health care. In 2010, when the health reform law was being debated in the public and in the halls of Congress, 46 million and millions more undocumented individuals lacked this important coverage. The high rates of uninsurance carry a large human toll, leading to unnecessary illness and disease, hospitalization and institutionalization, disability, and premature death. It also destabilizes our health care system, straining the emergency rooms and increasing the cost of health care spending, which in turn makes the health care system less dependable and less accessible.

Throughout 20 Days of ACA, we have discussed some of the ways people will gain coverage, for instance, through expanded access to Medicaid. We will also discuss later in the series how, starting in 2014 employers with over 50 employees must provide health insurance or face fines. But what about people whose employers are not compelled to provide insurance and who are not covered through public health programs like Medicare and Medicaid?

This is where the “exchanges” we have alluded to in previous posts comes into play.

So what exactly are these “exchanges?”

Exchanges are essentially new marketplaces, where individuals and small groups will be able to compare health insurance plans, determine their eligibility for public health coverage options (like CHIP and Medicaid), and enroll in the health insurance plans that correspond to them. Exchanges will also help families determine if they are eligible for government tax subsidies or credits to assist them in enrolling in new health insurance plans offered on the exchange.

The health reform law not only creates these exchanges, but also puts in place a series of regulations and protections in order to ensure quality and predictability across plans.

One of the ways health reform does this is by requiring that all insurance plans offered in these state exchanges cover a set of “essential health benefits.” These benefits are broken down into ten “buckets” of services that must be covered. We have already talked about two of these buckets, maternity & newborn care and preventive health, but the other buckets include services like mental health, substance abuse counseling, pediatric care including oral and vision,  and emergency services.

The ACA also requires that outreach and enrollment, including an insurance plan’s summary of benefits  as well as information about appealing insurance decisions, in the state exchanges be culturally and linguistically appropriate.

Health plans offered in the exchanges are also prohibited from discriminating on the basis of a consumer’s “pre-existing” or current health status.

States are responsible for creating these exchanges and opening them up in late 2013. The federal government has provided guidelines as well as millions of dollars to help states do so.

How will this benefit Latinas, their families and their communities?

The availability of new health insurance exchanges starting in 2014 means Latinas and their families will have more options for coverage.

Starting in 2014, individuals and families living at 133% to 400% of the federal poverty rate (in 2010, this meant an annual incomes between $14,403 and $43,320  for an individual and between $24,352 to $73,240 for a family of three) will be eligible for tax credits in order to off-set some of the costs of enrolling in new health plans on the exchange.

Additionally, permanent residents will be able to purchase insurance through the exchanges and will be eligible for tax credits. According to reporting from FamiliesUSA, 5.7 Latino permanent residents will be eligible to enroll in these plans.

While we know that expanding access to health insurance is an important step towards securing meaningful access to quality and affordable health care for Latinas, their families and their communities.

And by requiring that these plans offer a floor of “essential health benefits,” this coverage will more meaningful for Latinas, for instance, since majority of individual and small group insurance plans do not currently cover maternity care.

To find out information about what your state is doing to establish exchanges, the Kaiser Family Foundation has create a state-by-state resource here. 

Keep stopping by for more in 20 Days of ACA!

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Last Friday, March 23rd, marked the two year anniversary of when President Barack Obama signed the Patient Protection and Affordable Care Act into law.

And the National Latina Institute for Reproductive Health said “Happy 2nd Birthday, ACA!” and celebrated the anniversary of this historic law, which stands poised to increase access to quality, affordable health care for millions of Latin@s.

Check out a blog post by our Executive Director, Jessica González-Rojas, on RH Reality Check entitled The Affordable Care Act: Hope for Health Equity for All.

She highlights the long-standing challenges faced by Latin@s in accessing affordable and quality health care:

Today, people of color account for one third of the population but make up one half of the uninsured. Latinos go uninsured at rates higher than any other racial or ethnic group. This lack of access to basic care leaves our communities unfairly saddled with much higher rates of chronic and preventable diseases than their fellow Americans.

Women of color face a double challenge, since we also encounter the discrimination that for years has led to disproportionately high insurance premiums for women. Conditions like pregnancy and even rape being categorized as pre-existing conditions, and arbitrary insurance company rules that have denied women affordable care and coverage.

She discusses how specific provisions of the law have already improved access to quality and affordable care for many Latinas and their families, for instance, by expanding health insurance coverage to 2.5 million young adults — including 736,000 Latinos — by allowing young adults under 26 to stay on their parent’s plans. She argues that as the ACA is further implemented, numerous other provisions, such as the Medicaid expansion, grants to Community Health Centers and no co-pays for contraception, will empower our communities to  “take better care of ourselves, and each other.”

Additionally, NLIRH has issued a press release to commemorate the second anniversary of the ACA’s signing into law.

From the press statement:

“We believe that everyone has a fundamental right to quality, affordable healthcare, including contraception. The passage of the Affordable Care Act brings millions of Latinas closer to that vision and ensures that they can make the healthiest decisions for themselves and their families,” said Jessica González-Rojas, executive director of the National Latina Institute. “For Latinas, who already face a disproportionate number of barriers to care, the ACA expands access to absolutely critical services, like life-saving screenings for cancer and domestic violence, and expands support for pregnant women and new mothers.”

And finally, NLIRH has joined 180 national, local and state advocates for equity and civil rights in health in celebrating the historic health care law, and particularly the steps it takes to dramatically reduce health disparities faced by Latinos and other communities of color.

Happy Birthday, ACA! We look forward to seeing you grow!

For more about the health reform law, please visit NLIRH’s resources and follow our blog series, 20 Days of ACA: Lifting Latin@ Voices for Health Reform.

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