Palette Magazine

What changes in health care can mean for you

By Jeff Borg

Though the initial attempt to repeal and replace the Affordable Care Act (ACA) failed last March, the news was short-lived. By April, talk of giving health care overhaul another shot gained traction, and by May 4th, the House of Representatives succeeded in passing a bill that would dismantle the ACA by removing its most maligned — and arguably most essential — components. The same bill also proposes sweeping changes to the current health care system. While it may be some time before any of this political wrangling has any effect on our daily lives, for many the outlook is uncertain at best — particularly the poor, the elderly and those living with pre-existing conditions. This affects a large swath of the LGBTQ community, so it’s imperative we become better informed of all the changes being proposed and how that affects us directly.


Money Matters

In Florida — the state with the highest rate of ACA enrollment — about 1.4 million people or more than 93 percent of those enrolled received financial aid to lower their monthly premiums last year according to the state’s Department of Health and Human Services. Simply put, an overwhelming majority of Floridians could not afford health coverage without assistance.

“Even with Obamacare, Medicaid was not expanded here,” says Tony Lima, executive director of SAVE. “[That’s] brutal for South Florida, where incomes are low and costs are high.”

When the House initially proposed the American Health Care Act (AHCA), the nonpartisan Congressional Budget Office projected that over a decade, that bill would cost 24 million people their insurance coverage and/or increase expenses for low-income people and those approaching 65. Nonetheless, doing away with Medicaid expansion, eliminating the fines imposed on people who opt out of coverage and reducing or dramatically changing subsidies for those who do enroll are all integral parts of what’s being discussed in all GOP proposals.


Ill Bill

One item that keeps coming up with little consensus on how it would be implemented revolves around allowing insurers to charge people with pre-existing conditions premium rates or banning them outright.

According to Lima, repealing the ACA would strip away the bit of progress that’s been made.

“Pre-existing conditions were not covered before the ACA. It was horrible for people who suffered with HIV,” says Lima.

“People transitioning were not covered, either,” he continued. “They were considered to have a pre-existing condition. Many are still not covered. Treatment is considered elective, although it’s medically necessary.”

For a segment of the population with higher rates of a number of conditions, ranging from breast and ovarian cancer to mental health issues, the issue of pre-existing conditions is critical.


Count Us In

So what should the LGBTQ community be doing? “Keep our elected leaders’ feet to the fire,” Lima replies. “Write, email, make calls, meet your reps in their offices. Stay engaged politically — on every front. ACA is not perfect, but it’s a good vehicle to build on.”

“We’re already not being included in the census,” Lima says, referring to the administration’s decision to keep sexual orientation and gender identity out of the decennial census — even though 75 members of Congress requested it.

“The ACA brought our issues out of the closet,” Lima says. Now it’s a matter of being aware of what’s at stake and fighting for it. For more information on how changes to the federal health care system can affect you, visit To find out who your representatives are and get their contact information visit