Last week was a historic one with the Supreme Court decision upholding the Constitutionality of the Affordable Care Act aka Obamacare.

A roundup of what the LGBTQ pundits, bloggers and publications are saying

Pam Spaulding has a rundown of wingnut responses to the decision, including the now-infamous declaration that just because the Supreme Court says it is Constitutional doesn’t make it so. ???? She also includes GOProud and Log Cabin Republicans for good measure.

The Stonewall Democrats praise the ruling as paving the way for LGBTQ Americans to access health care.

“The ACA goes a long way toward leveling the playing field for LGBT Americans to get access to quality and affordable healthcare. The LGBT community is disproportionately affected by certain conditions for which insurance companies routinely denied or discontinued coverage before the enactment of the ACA. This ruling upholding the ACA will ensure that all Americans will have better and more affordable healthcare in the future.”

The National Gay and Lesbian Task Force points out some concrete benefits.

*Starting in 2014, insurance companies cannot deny health care coverage simply because of a pre-existing condition, which will ensure people with HIV or who have received gender transition-related care will still be able to get the health care coverage they need.

*Starting in January 2014, each state must have a Health Benefit Exchange, a health insurance “supermarket” where individuals and families can buy quality health care plans at an affordable price. No state’s exchange may discriminate against consumers on the basis of sexual orientation or gender identity.

The Family Equality Council points out the benefits to LGBTQ families, including queer parents with young adult children.

“Today’s ruling, upholding the key provisions of the law, is incredible news for our families – especially the more than 80,000 young adult children of LGBT parents who have been given access to health insurance through the expansion of care under the Affordable Care Act,” said Family Equality Council Executive Director Jennifer Chrisler.  “We know that parents who are LGBT and raising children in our country are more likely to live in poverty and not have access to affordable healthcare. These are the families who will benefit the most from the law.” 

The HRC points out that the “decision is an important victory in the fight for healthcare equality.”  

The Trevor Project reminds us that youth win here. They also have a great piece on Huffpo.

“The Trevor Project is grateful that the Supreme Court upheld the important provision in the Affordable Care Act that will enable millions of Americans, including at-risk LGBTQ youth to gain access to healthcare coverage.”

Lambda Legal reminds us though that the victory still has the potential to hurt many vulnerable members of our community.

“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.”

And for a more in-depth legal analysis of the opinion, the precedent and the impact on future LGBT related matters check out this piece from Ari Ezra Waldman.

As with most important legal decisions, there are multiple interpretations and multiple victors. Sebelius preserved the ACA, and that irks conservatives, but it did so in a way that should please conservatives in the long run. It also gut the ACA’s Medicaid expansion, which will have deleterious effects on the HIV-positive community. But, these developments should not hide the facts that (a) the President’s signature legislative achievement survives, and (b) upholding the ACA is very much consistent with a judicial philosophy that will strike down DOMA and other antigay laws

Overall, there’s cause to celebrate but it is important to recognize that the ACA does not fix healthcare. It repairs some of the damage, but there are people who are still going to go without and its a moral imperative that we continue to advocate for them, including our brothers and sisters living with HIV who may continue to suffer discrimination and barriers to quality care.

Something else to consider – by limiting federal power to control Medicaid, there is the potential for federal guidelines requiring Medicaid funded hospitals to provide visitation to be ignored. I’m still waiting for more feedback on that angle, but it reinforces the principle that we need our rights codified in law.

However, as someone with a preexisting condition, I am heartened. I am also heartened because my health insurance is through my partner’s employer – something that could change as well all know.

The onus now will be, for me at least, what is Pennsylvania going to do. For starters, will Pennsylvania expand Medicaid?

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