Our federal government has recently taken important steps to help ensure that the basic health needs of LGBT Americans are fairly met. It's a welcome development. But there is much more to do, especially for LGBT older people, so that the steps just announced translate into real action.
First, the good news. Earlier this month, the U.S. Department of Health and Human Services announced several actions it will take to improve the health and well-being of LGBT people. These actions, which start to remedy the federal government's historic disregard for LGBT health, range from committing to increase the number of federally-funded health surveys that collect sexual orientation and gender identity data (a critical need - how can we effectively address LGBT health needs if we can't document them because the federal government excludes LGBT data from its surveys?), to measures to help ensure that current and future health professionals will be trained to provide appropriate care to LGBT people.
For LGBT older people, the most significant announcement was that HHS will instruct the states that they are empowered to treat same-sex partners the same as married heterosexual couples when it comes to protection from "spousal impoverishment" under Medicaid.
Why is this so important? Medicaid, the single largest payer for long-term care in the U.S., requires an individual to spend down all of his or her assets to become eligible for long-term care coverage like nursing care, assisted living and home care. For married heterosexual couples, Medicaid has exemptions to avoid forcing a healthy spouse to give up the family home and retirement savings - therefore living in poverty - to qualify a spouse for long-term care.
Until now, LGBT older couples have been denied these fundamental protections, which means that many LGBT elders have been forced to choose between obtaining long-term care and living in poverty.
States now have the ability to correct this gross inequity. Every state should do so immediately, since the status quo is inhumane and unconscionable. However, the federal government is not forcing states to take corrective actions but instead telling states they have the legal power to do so. The Obama administration has shown its support for LGBT older people on this front, but the battle has now moved to the state level. In order for this problem to be truly fixed, States must act. Advocates working at the local and state levels must engage their state officials in this conversation to make sure they do what is right.
At SAGE, we have heard too many stories of LGBT elders losing everything - jobs, life savings, the homes they've lived in for years - to care for a loved one. Now that the Obama administration has taken the critical first step, we are determined to work with our 21 SAGE affiliates around the country, and our partners nationwide, to ensure that all states do the right thing.
I encourage everyone in our community to stand with LGBT older people and call on States to ensure that nobody else is thrown into homelessness and poverty so that their partner can get the long-term care they need. LGBT older people, like all elders, have the right to age with dignity and respect.