Gay-Rights Groups See Gains In House Health Bill

Gay-civil-rights groups have sought certain changes in health care policy for years without success. Now they've got a chance because of several provisions included in the House health care bill passed Saturday.

One provision would end a tax penalty for same-sex couples. "Today when employers offer health coverage to an employee's domestic partner, the value of that coverage is treated as taxable income to the employee," says Allison Herwitt, legislative director for the Human Rights Campaign.

For a heterosexual couple, there's no tax if a husband puts his wife on the insurance he gets through his company — or if a wife puts her husband on her insurance. But federal tax policy doesn't treat same-sex couples that way — since they can't legally marry.

Herwitt says the tax penalty can be significant: Typically it can cost up to $1,700 a year when the working partner is making $33,000 a year. So, she says, "many same-sex couples, particularly those of low and moderate incomes, can't afford this tax burden and they decline the health coverage for the partner."

Fixing A Medicaid 'Catch-22'

Another provision in the House bill would let states use Medicaid money to cover poor people with HIV, instead of waiting until they develop full-blown AIDS.

This could fix what's called "the Catch-22," says Jennifer Kates, director of HIV Policy for the Kaiser Family Foundation, an independent health care foundation. Right now, to qualify for Medicaid, you have to be poor or disabled, she explains. "For people with HIV, this has presented a real challenge since the advent of anti-retrovirals," she explains. "You have drugs that can prevent you from becoming really sick and disabled. Yet you can't get [into] the very program you need to access these drugs, because they're expensive."

The House bill would create a new program that is voluntary for states and would last for three years, covering people with HIV for the years before other sections of the House bill would eliminate the Catch-22. By 2013, the House bill would end the requirement that a person who doesn't otherwise qualify for Medicaid must have a disability to get access to the insurance program. The bill would expand the state and federal health insurance program to cover people with income up to 150 percent of the poverty limit — currently an individual who makes under about $16,000 a year or a family of four making less than $33,000 a year.

Ending Health Care Disparities Based On Sexual Orientation

There's another provision in the narrowly passed House bill that would let government gather data that look at disparities in health care based on sexual orientation and gender identity. And the bill includes language to prevent denial of health care.

Opposition to these new provisions didn't come up during the House debate. One reason may be that some of the groups opposed in the past were focused on other fights, including one to restrict funding for abortion.

But none of the provisions are in the Senate bills. So supporters are getting ready to protect them when — and if — the Senate and House have to reconcile their different health bills.