Our work for this meeting started beforehand as the National Gay and Lesbian Task Force folk stepped in to organize a call between the different community participants. My first impression was while the number of attendees grows each year this year it took a larger jump. There were reps from most every major LGBT group in the country and many HIV groups now too, like GMHC. This alone is a nice comment on change, because when I started going to these meetings years ago, many of these groups wouldn’t have had anyone expert enough on health to attend. I love the increased emphasis on health among our community organizations.
When we got to the meeting itself my first impression was the exact same — there were a lot more feds in the room than ever before. This meeting literally started years ago as about 12 people, now there were 40 community reps around the table, and nearly as many feds ringed around the sidelines. National Institutes of Health alone had three reps in the room, including the man trying to hire more LGBT staff and their main LGBT liaison. Gautam Raghavan, the White House LGBT liaison, was also there to bring our top issues back to White House strategists. This meeting is always packed with feedback from us, much of it aimed at specific HHS agencies, so I really appreciated seeing the agency staff there in person.
Then it was time for Sebelius debut, while this is our meeting with her, she’s only there for the first 15 minutes to give us top line info. What were her top line LGBT foci in the last year? 1. Access to health care and 2. Equal rights under the law, especially related to the Windsor/DOMA ruling. HHS had already taken action on several equal rights fronts pre-Windsor including: creating a National Resource Center on Aging; passing non-discrimination rulings for hospital and nursing home visitation; and passing non-discrimination rules for employment and HHS contractors. Now that DOMA ruling came out they bumped up the work on this, asking every agency to review their policies to ensure LGBT family inclusion. For example, HHS has now broadly adopted the “Celebration Policy” that IRS put out. This policy makes it standard for HHS to recognize legally married LGBT couples, even if they live in a state where the state doesn’t (yet) recognize them.
We know that LGBT people have a long history of access to health care barriers and that one in three low income LGBT people is uninsured. That’s why taking advantage of this historic open enrollment period for insurance exchanges is so critical for us. Secretary Sebelius pushed us to please do everything possible to help encourage people to enroll before the March 31st deadline. I agree, it’s why CenterLink’s Network for LGBT Health Equity has just put out more social-media ready ads for people to share. Please share them and visit Out2Enroll for more ideas.
Before the secretary left our designee, the ever-quick Harper Jean Tobin, was able to highlight a few of our consensus of top issues from our call. Our top ask was for a clear prohibition on overt discrimination in health care. Then we wanted LGBT cultural competence trainings for all providers; more clarity on acceptable practices in the insurance marketplace (there’s some HIV and trans exclusion hijinks going down in some states); quick action once the Medicare transgender ruling comes down; better measures for and more data collection on trans people; more research on many topics; and smart attention to legacy planning as we inch nearer an administration change.
Then it came time for the Chairs of the HHS LGBT Issues Coordinating Committee to hear our individual priorities. The meeting ran long as we all got our 90 seconds to chime in. This list really covered most everything anyone could think of, it’s a testament again to the depth of our joint work on health that there’s activity on so many fronts.
What were my top priorities for the administration in the coming year?
First, tobacco. We’ve developed a great depth of HIV work in part because the feds prioritize it, as they should. Considering tobacco is our top health burden by far, we need the feds to use that model to do more to prioritize LGBT tobacco. The fact that since 1988 NIH has only funded nine studies on LGBT tobacco use and only a handful more on cancer is a shame and the first area to fix.
Second, data. The feds may be pleased with more trans data collection on state surveys, but they’re spreading a measure that is only tuned to LGB across the federal surveys — including replacing a trans inclusive question on the smoking survey with this new LGB question. So we need them to start spreading trans data collection across federal surveys too, not just the states’ surveys.
Third, legacy planning. It’s a sad truth that our health integration is dependent on politics, but until science rules the day, we have to brace ourselves for internal discrimination after an administration change. One of the most powerful things HHS can do to help preserve progress is to finally declare LGBT people a legally designated health disparity population. There’s ample evidence to support the move and once it’s done you’ll see LGBT listed alongside other disparity populations on funding announcements across HHS, regardless of who’s in the Executive branch.
That’s the report! It was a vibrant meeting, I look forward to seeing how HHS turns LGBT health priorities into an action plan for the coming year.
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