LGBT ACA Provisions

The movement of the gay and lesbian population in the United States is one that has been in progress since the early 1900s, and is still facing overwhelming controversy and backlash today. The push for gay liberation in a country founded on Christian morals and beliefs has subsequently led to struggles over equality of marriage, adoption, jobs, and healthcare. One side of the controversy argues that every individual deserves the same rights, while the opposing mindset argues that being homosexual puts you into a group of people that is different, and will therefore be treated as such.

In 2015, groundbreaking advancements were made in the LGBT community, yet they still do not have specific protections in America’s Constitution. Recently, problems have once again threatened the community due to a conservative leaning government. It is important to bring attention to these issues because according to Samantha Allen of The Daily Beast, 7% of America aligns with LGBT. This number is growing as people become more accepting and comfortable with coming out. With these advancements, the Constitution has to include amendments that protect LGBT rights since there are none currently in place that explicitly state these protections.

This public health policy paper will discuss and outline the Affordable Care Act (ACA) as well as barriers and controversies surrounding the policy and its relevance in nursing profession. The ACA will eventually affect everyone. Statistics reflecting United States health outcomes have proven the need for the initiation of policy formation within the United States healthcare system. “In March 2010, President Obama signed into law a comprehensive health reform, the Patient Protection and Affordable Care Act (ACA).” (Estes, Chapman, Dodd, Hollister, Harrington, 2013, p. 144) The ACA promotes preventive care—including related services and family planning—that should result in improved health outcomes and

A great amount of problems still exist in LGBT workplaces, rights in the sphere have evolved and there are signs for a better and brighter future for the community. “The government has announced that it will be advancing legislation to amend section 37.1 of the employment equality act, which currently allows religious—run institutions, such as schools and hospitals to discriminate against LGBT employees. But the amendment will not protect every worker, as Rob Buchanan reports.” (BUCHANAN)

Regarding access to healthcare, transgender individuals often face the most obstructive barriers when attempting to receive care. Whether they are seeking access to hormones, therapy, general health services, reproductive healthcare, or specialty healthcare, transgender patients typically cannot get what they need without jumping through many hoops or hiding their identities. This occurs especially so in cases of intersecting identities -- where an individual is not just transgender, but is transgender and a person of color, disabled, gay, indigenous, undocumented, poor, etc. These intersecting identities interact in multifaceted ways to produce even more barriers for trans individuals seeking healthcare due to healthcare provider bias, insurance requirements, and doctors’ general unwillingness to help coupled with inaccessibility founded on racism, transphobia, homophobia, mental illness stigmatization, etc.

In the aftermath of the Supreme Court Case Obergefell v. Hodges (2015) which nationally legalized same sex marriage, the religious right has felt that protections on religious liberty in this country have gone under attack. As the LGBTQ+ movement gains more traction in mainstream media, local municipalities, and even state governments, many religiously conservative states legislatures have begun to fight back by passing laws that protect a person’s right to discriminate against the LGBTQ+ community because of religious objections. While a person’s right to abstain from participating in a business transaction concerning a same sex marriage has been widely debated (and continues to be widely debate) for some time now, the new anti-transgender

Relocating into a senior care facilities can be a frightening experience for the aging population. Getting familiar with new surroundings, new organization structure, and new people that can cause anxiety to rise. For a Lesbian, Gay, Bisexual, Transgender and Queer individual, this experience can be traumatic. The fear of harassment, hostility, and neglect by healthcare providers and caretakers can keep LGBTQ people from seeking care until their health begins to critically decline. LGBTQ cultural competency training is highly recommended for healthcare professionals and social service organizations. The greatest barrier that prevents quality health care for LGBTQ people is the lack of competence among the healthcare professionals.

Societal beliefs and values influence the Affordable Care act. The health care budget is under constraint, how to provide the most recent and enhanced health care while saving money has become a major issue. With this new health reform, millions of Americans who could not afford insurance with their employers or are uninsured due to lack of employment have the opportunity to become insured. The major economic change in this society has created enormous challenges for workers, families, as well as employers. The implementation of this act reduced this plague in the health delivery system.

The Patient Protection and Affordable Care Act (ACA) was signed into law in 2010. The ACA is considered the most expansive healthcare reform legislation in the United States since the formation of Medicaid and Medicare in 1965 (Berg & Dickow, 2014). The creation of the ACA ushered in a new progression for the United States healthcare system that put an emphasis on preventive services and primary care (Berg & Dickow, 2014). The ACA also aided in the public problem of the being uninsured in this country. It worked to provide insurance coverage to millions within the United States who are currently uninsured. The ACA is also working to combat the problem areas within the current healthcare system that are of need of modification so that the consumer needs for safe care and improved health outcomes are met (Berg & Dickow, 2014). The Patient Protection and Affordable Care Act’s goals are to the address many different components of reform. It addresses implementing ways for quality, affordable health care for all Americans, the role of pubic programs, enhancing the quality and efficiency of health care, the prevention of chronic disease as well as improving public health, the health care workforce, improved transparency and program integrity policies, improve the access to innovative medical therapies, community living assistance services and supports, and lastly, revenue provisions (Berg & Dickow, 2014).

In this paper I plan to discuss an increasingly difficult topic of The Patient Protection and Affordable Care Act. I will go over the basics of the act including who founded it, when, what it states as well as what its purpose is. I will also discuss the nine titles of the Affordable Care Act. I will then go over how four of the nine titles have affected how nurses provide care. I will finalize my paper by reflecting upon what I have learned from the Affordable Care Act.

All families face challenges in their everyday life. For some, the challenges are easier to handle while for others, surmounting those challenges can be more difficult. Over the years, the LGBT community in the US has faced many hurdles. Whether it’s the legalization of same-sex marriage to adoption rights to alimony, child support and child custody in case of divorce, legislation specific to gay and lesbian couples still has a long way to go.

Under the Obamacare, only employers who owned a “closely-held” corporation could file a religious exemption including houses of worship and the Trump administration believed that all corporations should have the “same protections” and be able to qualify for an exemption. (Pear 40). This concerns Pear’s audience of women rights advocates, women in the Obamacare program and the federal government because women right advocates will most likely argue that Trump’s mandate infringes women's right to seek contraceptive, many women in the Obamacare program will now be responsible for paying contraceptive coverage and the federal government will need to observe how the public reacts to this impactful change to health care.

Sexual and social stigmas largely affect the health of the lesbian, gay, bisexual and transgender (LGBT) population. While many reports from the Institute of Medicine, Healthy People 2020 and the Agency for Healthcare Research and Quality recognize a need to improve the quality of health care, barriers still remain. LGBT patients face legal discrimination, especially with insurance, a lack of social programs, and limited access to providers competent in LGBT health care. Although the Affordable Care Act increased access to care for LGBT patients, unless these patients feel understood by providers and develop trust in the system, they are not likely to utilize care. Healthcare providers need to recognize how these vulnerabilities, as well as persistent racism and stigma linked to sexual orientation and gender identity, make the healthcare needs of LGBT patients more challenging than the general population. Healthcare providers also need to promote cultural competence within this population and broaden their clinical lens to include health promotion, in addition to addressing concerns mentioned above within the population. Additionally, medical and nursing schools need to ensure that future providers are adequately educated by including information about this population in the curriculum.

Even though the Supreme Court’s ruling has brought marriage equality to all 50 states, 31 states still lack clear, fully-inclusive non-discrimination protections for LGBT citizens. This means that despite the ruling, LGBT Americans can get legally married but still be at risk of being denied services for who they are or risk being fired simply for getting married and wearing their wedding ring to the office the next day. Discrimination is a real and persistent problem for too many LGBT Americans. Nearly

This law directly impacts LGBT individuals because they can no longer be discriminated against for having a preexisting conditions, such as HIV. “…provides to all eligible individuals health insurance coverage that does not impose any preexisting condition exclusion with respect to such coverage” (P 36). The bill also prohibits discrimination based on medical history, genetic information, or any other health status-related factor. Again, the bill is aiming towards equality amongst genders, which will benefit our society as a