Monthly Archives: September 2017

We stand with 114 other national organizations: this ACA repeal attacks America’s most vulnerable

This morning, Our Family Coalition joined with 114 other national organizations in expressing our opposition to the Graham-Cassidy-Heller-Johnson proposal to repeal and replace the Affordable Care Act. From the letter: “We are deeply concerned about the negative impact that the Graham-Cassidy bill would have on many vulnerable and marginalized communities—including the LGBTQ community—that already face systemic discrimination and healthcare disparities.”

Full text below and in PDF form here.

United States Senate
Washington, DC 20510
September 25, 2017/

Dear Senator:

On behalf of the undersigned organizations representing millions of people who support equality for lesbian, gay, bisexual, transgender, and queer (LGBTQ) people nationwide, we write to express our opposition to the Graham-Cassidy-Heller-Johnson (Graham-Cassidy) proposal, and its underlying provisions to repeal and replace the Affordable Care Act (ACA). We are deeply concerned about the negative impact that the Graham-Cassidy bill would have on many vulnerable and marginalized communities—including the LGBTQ community—that already face systemic discrimination and healthcare disparities.

The ACA has served as a lifeline for millions of LGBTQ people who too often have found themselves cut off from critical healthcare services.(1) Prior to implementation of the ACA, LGBTQ people had some of the lowest insured rates of any population in the country. The individual market reforms, including the ban on preexisting condition exclusions, have made it possible for many in our community to obtain health insurance for the first time in their lives. Thanks to the ACA, from 2013-2017, the uninsurance rate for low- and middle-income LGBTQ people was reduced by 35%.(2) There is evidence that this reduction has been greater in states that opted for the Medicaid expansion,(3) and currently 1.8 million LGBTQ people rely on Medicaid.4 For those with particularly low incomes – under 250% of the federal poverty level – 40% of LGBTQ, compared with 22% of non-LGBTQ people, rely on Medicaid. For many people living with HIV, as one example, protections for those with pre-existing conditions has made insurance affordable and treatment accessible. Tens of thousands of people living with HIV have qualified for care under the Medicaid expansion, gaining access to life-saving treatments before becoming disabled by the virus. As a result, people living with HIV are able to have healthier and longer lives.

The Graham-Cassidy proposal will have a detrimental impact on the positive trend of health coverage for LGBTQ people and so many other vulnerable populations. Under previous repeal and replace legislation with comparable provisions for block-granting Medicaid the Congressional Budget Office projected 32 million people could ultimately lose coverage.(4) These projections foreshadow an unacceptable growth in the uninsured rate and an equally unacceptable exacerbation of health care disparities.

The Graham-Cassidy proposal fundamentally changes the Medicaid program, imposing a per capita cap funding structure and terminating the expansion of the program under the ACA. The magnitude of the lost funding will have a swift, stark, and devastating impact on the most vulnerable among us: women and children, the elderly, people with disabilities, and persons living with HIV. The legislation also strips the requirement to cover essential health benefits under the Medicaid expansion, leaving millions without access to the critical benefits that often save lives, such as substance abuse treatment and mental healthcare services.

The bill will also increase premiums for people with pre-existing conditions, including many significant, chronic health conditions for which LGBTQ people are at greater risk of experiencing relative to their peers. For example, people with major depressive disorder will see a premium surcharge of $8,490, while someone with breast cancer will see a surcharge of $28,660.(5) Research shows that 65% of LGBTQ people have a pre-existing medical condition, such as diabetes or heart disease.(6) Rather than increasing coverage, passage of this bill will cause millions of people to lose coverage while making coverage unaffordable for those who remain in the market.

Graham-Cassidy would give states broad waiver authority to eliminate the ACA’s core protections for people with pre-existing health conditions. Insurers would still have to offer coverage to those with pre-existing conditions, but they could make such coverage so expensive that it would be essentially meaningless. For LGBTQ older adults, many of whom face pronounced health disparities in physical and mental health, including depression, high blood pressure, heart disease, cholesterol, diabetes, obesity, and HIV/AIDS, cost increases of this magnitude would result in the loss of health care coverage.

Prior to the ACA, employer-provided health plans frequently limited the maximum amount of coverage employees could receive over their lifetime. In 2009, 59% of covered employees had health plans with lifetime maximums, meaning they could face bankruptcy if they encountered serious health problems and were left unable to cover their healthcare costs.(7) By allowing states to seek waivers to specified essential health benefit requirements, the Graham-Cassidy proposal gives states—and subsequently employers—the ability to narrow the definition of these essential health benefits. Ultimately, this would dismantle the ACA’s ban on lifetime limits and annual out-of-pocket spending limits for essential health benefits, once again leaving individuals to risk bankruptcy in order to obtain basic healthcare.(8)

LGBTQ people, particularly people of color and those living with HIV, face systemic discrimination and health disparities, which the ACA was helping to address. Graham-Cassidy would take us backward, shredding the health care safety net and leaving many in our community to risk bankruptcy in order to obtain basic health care. The one-two punch of gutting Medicaid and eliminating the ACA’s marketplace subsidies would strip coverage away from millions and inflict some of its worst harm on LGBTQ people, who already experience health disparities because of economic disadvantage and discrimination.

The provision barring Planned Parenthood and its affiliated clinics from participating in essential public health programs not only violates the procedural requirements of legislation adopted under budget reconciliation, it constitutes terrible health policy. Barring these clinics from receiving federal reimbursement for care provided will jeopardize the ability of these providers to deliver preventive healthcare services, such as cancer screenings and STD and HIV testing, as well as services like gender transition-related care that may not be offered elsewhere in many communities. Often, health centers such as Planned Parenthood offer the only culturally competent healthcare available to LGBTQ people, especially in rural and isolated areas. Rather than improving care options, Graham-Cassidy would disproportionately impact people— including people of color, immigrants, young people, and members of the LGBTQ community— who already face structural barriers to accessing care.

We strongly urge the members of the Senate to reject provisions such as those contained in the Graham-Cassidy-Heller-Johnson proposal that would harm millions of Americans and deny them the health benefits that save lives.

Sincerely,

Adolescent Counseling Services/Outlet • AIDS Foundation of Chicago • AIDS United • Alaskans Together For Equality • Alliance For Full Acceptance (AFFA • American Civil Liberties Union American Psychological Association • APLA Health • Asian & Pacific Islander American Health Forum • Basic Rights Oregon • BiNet USA • California LGBT Health and Human Services Network • Callen-Lorde Community Health Center • Center For Black Equity CenterLink: The Community of LGBT Centers • Colorado Consumer Health Initiative • Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR) • Community Research Initiative of New England • Consumer Health First • Dab the AIDS Bear Project • Equal Rights Washington • Equality Arizona • Equality California • Equality Federation • Equality Florida • Equality Michigan • Equality North Carolina • Equality Ohio • Equality Pennsylvania • Equality Texas • Equality Utah • Equality Virginia Equality • Maine • Fair Wisconsin • Family Equality Council • Fenway Health • Forward Together • Freedom Oklahoma • Gender Health Center • Georgia Equality • Georgians for a Healthy Future • GLBTQ Legal Advocates & Defenders (GLAD) • GLMA: Health Professionals Advancing LGBT Equality • HealthRIGHT 360 • HIV Medicine Association • Human Rights Campaign • Jackson Cty Democrats (OR) LGBTQ Caucus • JCD LGBTQ Caucus (Oregon) • Justice in Aging • Lambda Legal • LGBT Center of Raleigh • Liberty City Democratic Club • Los Angeles LGBT Center • Lotus Rising Project • LPAC • MassEquality.org • Mazzoni Center • Minnesota AIDS Projec • MomsRising • Montana Human Rights Network • Movement Advancement Project • NASTAD • National Asian Pacific American Women’s Forum (NAPAWF) • National Black Justice Coalition • National Center for Lesbian Rights • National Center for Transgender Equality • National Coalition for LGBT Health • National Coalition of Anti-Violence Programs • National Council of Jewish Women • National Gay & Lesbian Chamber of Commerce (NGLCC) • National Health Law Program • National LGBT Bar Association • National LGBTQ Task Force Action Fund • National Queer Asian Pacific Islander Alliance (NQAPIA) • NEAT – the National Equality Action Team • NMAC • One Colorado • Our Family Coalition • Out2Enroll • OutFront Minnesota • OutServe-SLDN • Palmetto Projec • People For the American Way • PFLAG National • Pride at Work • Progressive Leadership Alliance of Nevada • PROMO • Resource Center (Dallas, TX) • Rogue Rainbow Elders • Ryan White Medical Providers Coalition • Sacramento LGBT Community Center • SAGE (Advocacy & Services for LGBT Elders) • SC Equality • SCPHCA-SCMHP • Secular Coalition for America • SEIU District 1199 WV/KY/OH • Sexuality Information and Education Council of the U.S. (SIECUS) • Southern AIDS Coalition • Southern HIV/AIDS Strategy Initiative • The AIDS Institute • The Center for American Progress • The Gay and Lesbian Community Center of Southern Nevada • The Health Initiative • The Lesbian, Gay, Bisexual & Transgender Community Center • The National Latina Institute for Reproductive Health • The Pride Center at Equality Park • The Tennessee Transgender Political Coalition • The Trevor Project • Transgender Law Center • True Colors Fund • Universal Health Care Action Network of Ohio • URGE: Unite for Reproductive & Gender Equity • Whitman-Walker Health • Wyoming Equality • Young Invincibles

(1) http://hrms.urban.org/quicktakes/Uninsurance-Rate-Nearly-Halved-for-Lesbian-Gay-and-Bisexual-Adults-sinceMid-2013.html

(2) https://www.americanprogress.org/issues/lgbt/news/2017/03/22/428970/repealing-affordable-care-act-badmedicine-lgbt-communities/

(3) https://www.americanprogress.org/issues/lgbt/reports/2014/11/17/101575/moving-the-needle/

(4) https://www.cbpp.org/research/health/like-other-aca-repeal-bills-cassidy-graham-plan-would-add-millions-touninsured

(5) https://www.americanprogress.org/issues/healthcare/news/2017/09/18/439091/graham-cassidy-aca-repeal-billcause-huge-premium-increases-people-pre-existing-conditions/

(6) https://www.americanprogress.org/issues/lgbt/news/2017/07/06/435452/senate-health-care-bill-devastating-lgbtqpeople/

(7) https://kaiserfamilyfoundation.files.wordpress.com/2013/04/7936.pdf

(8) https://www.brookings.edu/blog/up-front/2017/03/24/new-changes-to-essential-benefits-in-gop-health-billcould-jeopardize-protections-against-catastrophic-costs-even-for-people-with-job-based-coverage/

https://www.brookings.edu/2017/05/02/allowing-states-to-define-essential-health-benefits-could-weaken-acaprotections-against-catastrophic-costs-for-people-with-employer-coverage-nationwide/

Our Annual LGBTQ-Inclusive Preschool & Kindergarten Fair: an SF Tradition

by OFC Education Director Tarah Fleming

Our Family Coalition’s 5th Annual LGBTQ Inclusive Preschool & Kindergarten Fair was an incredible success!

Over 35 schools set up display tables at San Francisco Day School to show off their teachers and curriculum that foster respectful learning environments for all families. Over 90 caregivers strolled through with toddlers and infant carriers to have introductory conversations with school leaders. Families learned about the different community partners that worked together with Our Family Coalition to host this important and informative evening. The San Francisco Library displayed books featuring all kinds of families, and Community Well served fresh scones and berries while informing caregivers about the free classes they host for parents. San Francisco Unified and Parents for Public Schools took the mic and talked about the school enrollment process and People of Color in Independent Schools shared about their upcoming workshops.

As we enter into an era more aware and inclusive of LGBTQ families in schools, it is important to remember that it is also a time where the opposition is feeling emboldened to try and limit visibility, access and even rights. For this reason OFC is fully committed to creating spaces like the LGBTQ Inclusive Preschool & Kindergarten Fair, which also compliments the work of the FAIR Education Act, signed into law in 2011 and designed to ensure LGBTQ People are fairly represented in California public school curriculum and text books.

As we continue to engage families, teachers, community partners and school leaders in the work of creating equitable and just schools for all, we are reminded of the values many of us learned in kindergarten; love yourself and love others. This is much easier to do when your family is not only reflected back to you in all your school books, but loved and respected by the entire school community.

Check out the schools that participated here.

Three Things Parents of Toddlers and Young Kids Need to Know

We’re offering a fantastic workshop this Thursday, September 14: The First Five Years: Developmental Milestones and Parenting Matters.  In anticipation of it, we spoke with Dr. Dhara Meghani from University of San Francisco’s Parentline, an incredible local resource for parents offering free, confidential counseling (!) for parents of children 0-3 years old, and the source of our expert workshop facilitation.

Our question to Dr. Meghani: What three things do you think are most important for parents and caregivers to know about their babies, toddlers, and young kids, and yet most commonly misunderstood? Here’s what she had to say.

One: it’s normal for a baby to take a while to settle into a compatible sleep pattern. This is definitely a large source of family stress and anxiety. Knowing more about what a baby is capable of can help. And setting expectations realistically may alleviate concern.

Two: cognitive development is not a linear process: backsliding is not just common, it’s necessary. Just prepare for regressions and try to enjoy the ride. Dr. Meghani’s example was  brilliant: you know when you’re cleaning out the fridge? And the first thing you have to do is empty it all out on the kitchen counter? Well, that’s what kids are doing when they’re on the verge of a major developmental leap: in order to create the capacity for that new cognitive capacity, their brains literally prune out unnecessary neuronal pathways.

Three: it is totally normal to be freaked out! Rather than beat yourself up about being stressed, just keep your pediatrician on speed dial, or contact Parentline for support. Support groups for parents and caregivers – like those offered from organizations like Our Family Coalition – can provide critical life lines as well. Knowing others are going through what you’re going through can offer perspective, companionship, and sometimes some helpful new angles on a sticky challenge.

Want more of all this? Lindsey Rogers and Alicia Ranucci, doctoral students in the Clinical Psychology PsyD Program at USF work at Parentline, and will have a whole lot more to say at our workshop The First Five Years: Developmental Milestones and Parenting Matters, held this Thursday, September 14, 6-8pm at our San Francisco office. Advance registration always helpful (we calculate dinner and childcare based on it), but drop-ins welcome.

Help us get the expanded Parental Leave bill across the finish line!


From our colleagues at the California Work and Family Coalition:

Great news! It looks like we have a deal with the Governor’s office on our priority legislation – parental leave bill (SB 63 – Jackson) – and he is planning to sign! 

This is exciting news, but we still need to get the bill through the Assembly. Please call your Assemblymembers TODAY in their Capitol offices to urge them to vote “AYE” on SB 63. (Find your representative’s office number here.)

Here’s a sample script:
Hello, I live in Assemblymember __________________’s district (optional: I am a mother, father, health care provider, teacher, small business owner etc) and I’m calling to urge his/her ‘aye’ (or yes) vote on SB 63 (Jackson) the New Parent Leave Act. This is an important bill that allows more parents to bond with their new children. Do you know how the Assemblymember plans to vote on SB 63?

If you have a relationship with your Assemblymember or their office, and can have an even more detailed conversation, here’s what we’re stressing regarding the amendments to the bill: this provision creates a new mediation pilot program within the Department of Fair Employment and Housing so that the parties can elect to mediate their dispute before moving to the stage of filing a lawsuit.

Are you able to do more than call? If you are available, please also join us in the Capitol on Monday, September 11 or Tuesday, September 12 as we make the rounds to Assemblymember offices. We’ll be meeting at the 6th Floor Cafeteria at 10:00 am and again at 12:30 to connect before making the rounds.

I do hope some of you will join us at the Capitol on Monday or Tuesday next week. The bill is likely to be voted on on Tuesday in the Assembly.

In Solidarity,

Jenya Cassidy
CA Work and Family Coalition