Tag Archives: health care

Help Expand Medicaid in Montana!

by D Gregory Smith
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This session the Montana Legislature has an incredible opportunity to expand access to healthcare for 60,000 Montanans! Doing so would involve a minimal cost to the state, and have a major impact across our communities. Our legislators can do this by choosing to expand eligibility in the Medicaid program for individuals who live at or below 133% of the federal poverty level.  It will take a lot of effort on the ground across the state to pass this policy and we need your help!
We’re asking you to contact your Representative and Senator today and urge them to support Medicaid expansion! If we’re able to pass this expansion, it would be a huge victory for human rights in this state!
You can call and leave a message for your legislators at 406-444-4800 or you can fill out an online form by clicking here.  We’ve included some key facts and talking points at the end of this message.   Click here to find out who your legislators are.
We’re asking for your help because this is a once in a generation chance to expand an effective public healthcare program and get Montanans the care they need! But this policy won’t just help our neighbors who can’t afford health insurance. It will also have an incredible effect in our local and state economies. By expanding eligibility to our state Medicaid program, Montana will be investing in our workforce, creating new jobs, and giving a much needed boost to our economy. For more details on the economic impact of Medicaid expansion click here.
Expanding our Medicaid program is the right choice for Montana.  If we make that choice, 100% of the costs of expansion will be paid for through federal funding for the first 3 years. Beginning in 2017, Montana will pick up a small portion of the costs, paying no more than 10% from 2020 forward. This means that by investing a small amount of state dollars in our administrative capacity to expand the program, we can open access to healthcare for up to 60,000 Montanans.
We are so excited about this opportunity, and we’ll keep you updated as this policy discussion progresses.  For now, we hope you’ll write your legislators and let them know how important it is to support Medicaid expansion! 
Thank you for your continued support!
Sincerely,
Kim Abbott
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Oregon Removes Barriers To Transition-related Care‏

by D Gregory Smith

From Basic Rights Oregon:

Basic Rights Oregon Header

Great news! The Insurance Division of the Department of Consumer and Business Services (DCBS) just announced that insurance companies doing business in Oregon must end discriminatory exclusions of medically-necessary healthcare for transgender Oregonians.

We all know someone who has been denied medically necessary care by an insurance company working to protect its bottom line. It’s unfair, painful, and downright dangerous when it happens. And for transgender people, these denials are often a fact of life.

Many transgender Oregonians are denied the ability to purchase health insurance or are denied coverage for basic, medically necessary care solely because they are transgender (watch a video of their stories here). These exclusions are wrong, discriminatory– and the Insurance Division has made it clear that this kind of discrimination has no place in Oregon.

The Insurance Division bulletin specifically states that:

  • Health insurers may not categorically exclude transgender patients from coverage.
  • Health insurers must provide coverage and cannot deny coverage of treatments for transgender policy holders if the same treatments are covered for other policy holders.
  • Health insurers may not deny treatment on the basis of a policy holder’s actual or perceived gender. That means that all policy holders can rely on annual exams, cancer screenings, and gender-specific health care, regardless of their gender on file.
  • The statewide mandate for coverage of mental health services must apply to transgender patients.

To learn more about this bulletin, or if you are denied care following this announcement, please refer to our Frequently Asked Questions sheet and to theInsurance Division website.

After years of work on this issue, the Trans Justice team at Basic Rights Oregon is celebrating a tremendous victory for trans, genderqueer, and gender non-conforming Oregonians. Portland resident and Trans Justice Working Group member Ray Crider said,

“For me, this coverage is preventive health care. As a transgender man, part of my daily routine is binding my chest to create a masculine appearance. This created health problems for me by restricting my breathing and causing inflammation in the wall of my lungs. As a result, I ended up in the emergency room several times for shortness of breath and chest pain. Doctors told me the only solution was to stop binding, but the surgery I needed ended up being the same cost as my emergency room visits. Transgender exclusions in insurance policies are a lose-lose proposition, and I’m glad they’re coming to an end.“

 

Basic Rights Oregon and transgender community leaders will continue working together to increase access to medically necessary care for trans Oregonians. And we’ll share more updates as this exciting bulletin is implemented.

 

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For Men Only- Your Sexual Health

by D Gregory Smith

From the National Association of State and Territorial AIDS Directors (NASTAD) and the National Coalition of STD Directors (NCSD) comes a new pamphlet aimed at helping men who have sex with men (MSM) take charge of their sexual heath:

“Whether you are gay, bisexual or any man who has sex with other men (MSM), there are certain health services that are important for you to talk about with your doctor to protect your sexual health. This brief pamphlet is designed to help you get the best sexual health care during your visit to the doctor.”

An amazing array of helpful information about special health concerns and working with your healthcare provider.

View “For Men Only- Your Sexual Health” here.

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Why HIV Testing and Treatment Are Still Issues

by D Gregory Smith

A key concept for anyone considering the success of anti-HIV treatment in improving the health of individuals and in preventing onward transmission in their communities is the ‘treatment cascade’ or ‘care continuum’. This shows how, at every stage, patients are not retained in the healthcare system or are unable to access the medical care they need.

(Source)

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Reminder: AIDS Is Alive And Well In Montana

by D Gregory Smith

Kim McGeehan wrote an article for the Bozeman Magpie about HIV in Montana- and shared some of my story along the way. Excerpt:

English: HIV-1 particles assembling at the sur...

English: HIV-1 particles assembling at the surface of an infected macrophage. Français : Des particules de HIV-1 s’assemblant à la surface d’un macrophage infecté. (Photo credit: Wikipedia)

“I wasn’t diagnosed because I was scared. Now, I have memory issues and damage to my joints. HIV attacks soft tissues in the body—gums, brain, liver—even if you don’t have outward symptoms, the virus can still be doing damage,” Smith says. “At first, there were no treatments. Now there is a lot we can do. We can stop it or slow it down. You can live a healthy life. If you are on your meds and have a low viral load, your risk of transmitting the disease can be as low as 4%.”

That isn’t permission to take behavioral risks, but information that should encourage people to take advantage of the services offered by AIDS Outreach. Those services include fast, free, anonymous HIV tests, an HIV-positive support group, educational literature, and condoms condoms condoms.

Americans will soon be able to purchase an over-the-counter, rapid-response HIV test, but Smith worries that dealing with a positive result alone will be challenging for folks: “Denial is such a strong force in the human psyche. I remember it in myself. I’m worried that someone might test positive and not tell anyone, not get counseling or medical care.”

Read the rest:

http://www.bozeman-magpie.com/perspective-full-article.php?article_id=502

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The Affordable Care Act & LGBT Persons

by D Gregory Smith

In 10,000 Same Sex Couples Magazine, an excellent overview of the benefits of the ACA for LGBT persons. Excerpt:

Nondiscrimination protection measures have been included in the Affordable Care Act, and significantly, by 2014, insurance companies will not be able to deny coverage based on pre-existing conditions such as HIV or transgendered medical history.

Increased services for preventive care and HIV testing and treatment have been included in the ACA.  As insurance companies will no longer be able to cancel or deny coverage based on pre-existing conditions, Americans living with HIV will have better access to care and to life-saving drugs, whereas currently, an estimated 25% of the 1.2 million Americans living with HIV in the United States have no health insurance coverage. Many of those living with HIV without insurance, or with insurance but consistently fearful of having it canceled due to a pre-existing condition, have been forced to pay out of pocket or seek other methods of treatment.

LGBTQ Activist Chris Barnett of San Francisco says: “I’ve been fortunate to have health coverage all my years of living with HIV, so pre-existing condition has thankfully never directly affected me. Though I must say, in my early years with this, late ’80s to early ’90s, I was fearful of using my insurance for fear of being redlined, so I paid for early treatment out of pocket, or found medical studies.”

As most states in America fail to recognize same-sex relationships, healthcare through a spouse’s workplace is not an option for many LGBTQ Americans. This often results in a high number of citizens forced to pay high prices for private insurance or to forgo having any insurance at all due to cost.  With ACA’s expansions to the affordability and accessibility of healthcare, more LGBTQ Americans will be able to be covered.

Read the rest here.

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Impact of Affordable Care Act On HIV/STD Prevention

by D Gregory Smith

Wondering about the Supreme Court’s decision on HIV/STD prevention and care? Some help from The National Coalition Of STD Directors:

Sexually transmitted disease

As you consider the impact of today’s Supreme Court ruling on the Affordable Care Act on different populations, I would like to share with you the impact of today’s ruling on our fight to prevent and treat sexually transmitted diseases.

Sexually transmitted diseases (STDs) remain a major epidemic in the United States.  Each year, there are approximately 19 million new cases of STDs, approximately half of which go undiagnosed and untreated[i], giving the  United States the highest STD rate in the industrialized world.[ii]

STDs cost the U.S. health care system $17 billion every year—and cost individuals even more in immediate and life-long health consequences, including infertility, higher risk of acquiring HIV, and certain cancers.[iii]

  • Young people will continue to have expanded coverage under their parent’s insurance.  Young people bear a disproportionate burden of STDs—those aged 15-25 make up half of the STDs contracted annually, but make up only one-fourth of the sexually active population.
  • Private insurance will continue to have to cover prevention services with no cost out-of pocket costs to patients.  Many of those who visit STD clinics are low-income and would not be able to receive prevention sexual health services without coverage by insurance.  While there is still work to be done for certain at-risk populations, such as men who have sex with men, expanded STD testing and  STI counseling will be covered by insurance under this expansion of preventative care in the law and it is a great start.
  •  The continued need for safety-net service providers is underscored.  With the narrowing of the Medicaid expansion provisions, the very real possibility exists that many low-income individuals will not have access to affordable health care coverage.  Patients at STD clinics are young, minority, and poor—populations that are bear a much higher burden of STD disease—and may be left without coverage in a state that may choose not to expand their Medicaid coverage.

HIV-specifics from Lambda Legal:

“This is a victory for all Americans, but in particular, the Court’s decision today will save the lives of many people living with HIV – as long as states do the right thing. The Affordable Care Act will finally allow people living with HIV to access medical advancements made years ago but that have so far remained out of reach of many. With continuing prevention education, early detection, and quality care for everyone living with HIV, we have the power to stem the HIV/AIDS epidemic.

“But this is not a complete victory, because today’s decision allows states to opt out of the Medicaid expansion that would provide insurance coverage for many low-income people who cannot otherwise afford it. Our continuing challenge will be to make sure that states opt to expand Medicaid so that more low-income people, and particularly those with HIV, can get the health care they urgently need.”

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Tester Stands Up

by D Gregory Smith

Senator Jon Tester’s office released the following today:

Jon Tester, U.S. Senator from Montana

Image via Wikipedia

Senator Jon Tester today released the following statement after voting against a controversial amendment by Sen. Roy Blunt, R-Mo., that would have allowed employers to deny health insurance coverage, including contraception, for any employee based on “moral convictions”:

“This is a reckless attempt to undermine individual freedom and restrict access to health care for women.  This measure is unprecedented and out-of-touch with Montana, and it would have prevented women from making their own healthcare decisions.”

The amendment did not define “moral convictions,” meaning an employer could have denied insurance coverage for anything from blood transfusions and diabetes screenings to HPV vaccinations and treatment of HIV.

The measure failed by a vote of 51-48, failing to reach the 60 votes needed for approval.

It sounds like it would have given employers the right to discriminate for insurance coverage.

I’m especially glad the release specifically mentioned HIV- we have hundreds of Montanans living with HIV who are enrolled in health insurance through their employers….

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Catholic Nuns File Amicus Brief Supporting Affordable Care Act

by D Gregory Smith

Some sisters have come out in favor of The Affordable Care Act, saying

(We) believe that a civilized society must ensure the provision of basic healthcare to its citizens regardless of their ability to pay for it. (We) further believe it is a moral imperative that all levels of government institute programs that ensure the poor receive such care. (We) believe Medicaid expansion under the Act is critical to the communities (we) serve.

Predictably, some “Catholic” websites are leading with headlines like “Liberal Nuns Support Obamacare”, and “Liberal Activist Nuns Want Socialized Medicine”.

Sigh. What’s wrong with these people? What do they think Jesus would charge for healthcare? And they’re theologically out of step with their church.

From ThinkProgress:

As further proof that conservative efforts to paint President Obama as the enemy of religion are a red herring, nearly two dozen leading Catholic nuns filed a brief in the Supreme Court last week supporting the president’s signature legislative accomplishment. The Catholic sisters who joined the brief include the leaders of many prominent religious orders providing health care and other services to the needy.

These nuns have unique stature to explain why their support for the Affordable Care Act flows from their faith, given that so many of them have devoted their lives to providing care to those most in need. Nevertheless, their views are hardly unique within their church’s hierarchy. Pope Benedict XVI called health care an “inalienable right,” and added that it is the “moral responsibility of nations to guarantee access to health care for all of their citizens.”

Duh. “Is the Pope Catholic?” may no longer be a rhetorical question- especially for catholic fanatics.

Oh- and Jesus healed for free….

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CDC Analysis: 4 out of 10 HIV-Diagnosed Not In Care

by D Gregory Smith

An analysis of epidemiological data by the Centers for Disease Control has arrived at a startling conclusion: as many as 4 out of 10 persons diagnosed with HIV do not remain in care.

Despite all the medical evidence which advocates early HIV treatment for a healthy life, people are still not accessing care. The specific reasons are unclear, but the National HIV Treatment Guidelines are very clear: Persons with HIV are to be tested for Viral Load and CD4 counts ever 3-4 months, unless they are considered “virus-suppressed” (usually with an undetectable viral load and normal CD4 count with no medication changes over a period of time), then it is every 6-12 months.

So, what’s happening?

In surveillance data from 13 regions, only 59% of people recently diagnosed with HIV had had a test for viral load or CD4-positive T-cell count within the previous year, according to Irene Hall, PhD, head of the CDC’s HIV incidence and case surveillance branch.

The finding implies that the remaining 41% are not under a physician’s continuing care, Hall said in a teleconference during the 2011 National HIV Prevention Conference in Atlanta.

The two tests are a “marker for being in care,” Hall told MedPage Today.

Maybe it’s time to start talking seriously about barriers to proper care, including discrimination, poverty, cultural issues and race.

At a time when we know treatment is prevention, it’s important that the members of our communities who are HIV infected receive the care they need.

I’m wondering if it’s about support. Many of the people in my HIV+ support groups help each other with their health care- talking honestly about issues, sharing resources- even giving each other rides to doc or lab visits. They stay on their meds, talk realistically about their health, exercise, pay closer attention to nutrition and reducing stress. They do it because they have people they can speak to honestly about their disease- people who know firsthand what it’s like. And, for the most part, they’re having incredible, fulfilling lives.

In my experience, it’s the people who are trying to deal with HIV on their own who don’t do so well.

Depression and fear can play an enormous part in healthcare apathy- and it’s a well-documented fact that fear and depression are alleviated by concern and compassion from family and friends- and involvement with others who share similar circumstances.

So, in the interest of trying to understand this better, I have a couple of questions:

Do you know anyone (maybe it’s you) with HIV who is not getting care for their disease? What can be done to get them into care?

I’d like to follow up with your responses- so feel free to contact me at Dgsma@hotmail.com if you are uncomfortable leaving a response in the thread.