#coverage levels for health insurance

[naukrisambad]

Navigating the Maze of Health Insurance Coverage

Health Insurance Coverage: In today’s uncertain world, having comprehensive health insurance coverage is not just a luxury; it’s a necessity. With the ever-increasing costs of medical care, understanding the intricacies of health insurance coverage is paramount for individuals and families alike. In this guide, we will delve deep into the world of health insurance coverage, unravelling its…

[wellhealthhub]

Type 2 Diabetes Once-a-Week Injection: A Revolutionary Breakthrough in Diabetes Management

Introduction Welcome, esteemed readers, to this all-encompassing and profound guide, a magnum opus exploring the groundbreaking, once-a-week injection for the management of Type 2 Diabetes. For those grappling with the pervasive impact of Type 2 Diabetes or those intimately associated with someone affected by this condition, the present article ardently endeavors to bestow upon you invaluable…

[tomorrowusa]

Don't risk a rerun of the 2000 election.

In the first presidential election of the 21st century many deluded progressives voted for Green Party candidate Ralph Nader.

Their foolishness gave us eight years of George W. Bush who plagued the country with two recessions (including the Great Recession) and two wars (one totally unnecessary and one which could have been avoided if he heeded an intelligence brief 5 weeks before 9/11).

Oh yeah, Dubya also appointed one conservative and one batshit crazy reactionary to the US Supreme Court. Roberts and Alito are still there.

Paul Waldman of the Washington Post offers some thoughts.

Why leftists should work their hearts out for Biden in 2024

Ask a Democrat with a long memory what the numbers 97,488 and 537 represent, and their face will twist into a grimace. The first is the number of votes Ralph Nader received in Florida in 2000 as the nominee of the Green Party; the second is the margin by which George W. Bush was eventually certified the winner of the state, handing him the White House. Now, with President Biden gearing up for reelection, talk of a spoiler candidate from the left is again in the air. That’s unfortunate, because here’s the truth: The past 2½ years under Biden have been a triumph for progressivism, even if it’s not in most people’s interest to admit it. This was not what most people expected from Biden, who ran as a relative moderate in the 2020 Democratic primary. His nomination was a victory for pragmatism with its eyes directed toward the center. But today, no one can honestly deny that Biden is the most progressive president since at least Lyndon B. Johnson. His judicial appointments are more diverse than those of any of his predecessors. He has directed more resources to combating climate change than any other president. Notwithstanding the opposition from the Supreme Court, his administration has moved aggressively to forgive and restructure student loans.

Three years ago the economy was in horrible shape because of Trump's mishandling of the pandemic. Now unemployment is steadily below 4%, job creation continues to exceed expectations, and wages are rising as unions gain strength. The post-pandemic, post-Afghan War inflation rate has receded to near normal levels; people in the 1970s would have sold their souls for a 3.2% (and dropping) inflation rate. And many of the effects of "Bidenomics" have yet to kick in.

And in a story that is criminally underappreciated, his administration’s policy reaction to the covid-induced recession of 2020 was revolutionary in precisely the ways any good leftist should favor. It embraced massive government intervention to stave off the worst economic impacts, including handing millions of families monthly checks (by expanding the child tax credit), giving all kids in public schools free meals, boosting unemployment insurance and extending health coverage to millions.

It worked. While inflation rose (as it did worldwide), the economy’s recovery has been blisteringly fast. It took more than six years for employment rates to return to what they were before the Great Recession hit in 2008, but we surpassed January 2020 jobs levels by the spring of 2022 — and have kept adding jobs ever since. To the idealistic leftist, that might feel like both old news and a partial victory at best. What about everything supporters of Bernie Sanders have found so thrilling about the Vermont senator’s vision of the future, from universal health care to free college? It’s true Biden was never going to deliver that, but to be honest, neither would Sanders had he been elected president. And that brings me to the heart of how people on the left ought to think about Biden and his reelection.

Biden has gotten things done. The US economy is doing better than those of almost every other advanced industrialized country.

Our rivals China and Russia are both worse off than they were three years ago. And NATO is not just united, it's growing.

Sadly, we still need to deal with a far right MAGA cult at home who would wreck the country just to get its own way.

Biden may be elderly and unexciting, but that is one of the reasons he won in 2020. Many people just wanted an end to the daily drama of Trump's capricious and incompetent rule by tweet. And a good portion of those people live in places that count greatly in elections – suburbs and exurbs.

Superhero films seem to be slipping in popularity. Hopefully that's a sign that voters are less likely to embrace self-appointed political messiahs to save them from themselves.

Good governance is a steady process – not a collection of magic tricks. Experienced and competent individuals who are not too far removed from the lives of the people they represent are the best people to have in government.

Paul Waldman concludes his column speaking from the heart as a liberal...

I’ve been in and around politics for many years, and even among liberals, I’ve almost always been one of the most liberal people in the room. Yet only since Biden’s election have I realized that I will probably never see a president as liberal as I’d like. It’s not an easy idea to make peace with. But it suggests a different way of thinking about elections — as one necessary step in a long, difficult process. The further you are to the left, the more important Biden’s reelection ought to be to you. It might require emotional (and policy) compromise, but for now, it’s also the most important tool you have to achieve progressive ends.

Exactly. Rightwingers take the long view. It took them 49 years but they eventually got Roe v. Wade overturned. To succeed, we need to look upon politics as an extended marathon rather as one short sprint.

Republicans may currently be bickering, but they will most likely unite behind whichever anti-abortion extremist they nominate.

It's necessary to get the word out now that the only way to defeat climate-denying, abortion-restricting, assault weapon-loving, race-baiting, homophobic Republicans is to vote Democratic.

[paper-mario-wiki]

may i ask why you want to move to japan specifically? wouldn't you be able to find a place to live in america?

tbh the differences in quality of life between countries are so stark that i can give 1 reason at a time and you'd understand why any of them individually would make me want to move.

here's 1 reason: insurance.

in the united states, i pay $450 a month for private health insurance. with that health insurance, i have a yearly deductible, which means that on top of the $5k+ a year I have to pay monthly just to HAVE the insurance, I also have several thousand in medical bills that I've got to pay out of pocket before my insurance begins covering things proper. and after i spend almost $10,000 to actually have my insurance start kicking in (which i have to meet every year, meaning in January I have to start paying the 10k all over again), i also have to pay coinsurance (the percentage of my healthcare that my insurance DOESNT cover), which is a different percentage and base rate based on what specific healthcare service I'm getting. even then, healthcare in the USA is significantly more expensive on a foundational level without insurance than most other countries.

in japan, the amount I could have been paying monthly for the government subsidized National Health Insurance was $5 because I was a student, but I didnt know how to apply for that so I paid the general price of $70 monthly. after that, starting immediately after you begin payment, the national health insurance covers 70%-90% of healthcare costs depending on tax bracket (higher coverage for those earning less). Japanese insurance ALSO has a deductible, which resets monthly instead of yearly, starting at around $150. if the amount that you pay out of pocket exceeds your monthly deductible and you still need healthcare services, you can apply for a reimbursement on all medical expenses for the rest of the month.

that is 1 reason i want to move away from the united states and back to japan.

[justinspoliticalcorner]

Amanda Marcotte at Salon:

Republicans know that their war on legal, accessible birth control is unpopular. But that's not stopping them because, as they learned from convicted felon Donald Trump, the way to hide what you're up to is simple: Lie. Lie a lot. Lie every time you open your mouth. Lie with a straight face, and have faith that the weak "fact checks" offered by the mainstream media don't matter. The Republican comfort levels with lying are sky-high in the era of Trump. Speaker of the House Mike Johnson, R-La., does it with a smirk, satisfied that no one can stop him. It is somehow still staggering how much they lie about birth control and their nefarious intentions toward it. The good news is that Democrats are taking action to cut through the GOP's thick forest of falsehoods.

On Wednesday, Senate Majority Leader Chuck Schumer, D-N.Y., held a vote on the Right to Contraception Act, which guarantees the right of an individual "to obtain contraceptives and to voluntarily engage in contraception." The legislation also protects the right of licensed health care providers "to provide contraceptives, contraception, and information, referrals, and services related to contraception." Despite loudly insisting they have no desire to take away birth control, all but two Republicans voted against the bill. This follows a 2022 vote on the bill in the House, in which all but 8 Republicans voted against the right to use contraception.

Republicans' excuses this week ranged from obvious lies to obfuscation tactics which ultimately amount to lies. Sen. John Cornyn, R-Tex., called the vote "phony" because "contraception, to my knowledge, is not illegal." But of course, no one is saying it's illegal — yet. The point of Wednesday's vote was preventive, to ensure the right to birth control in the face of overt calls, including from Supreme Court Justice Clarence Thomas, to "revisit" the legality of contraception now that the right to abortion is no longer federally protected.  Sen. Katie Britt, R-Ala., whose State of the Union response introduced the nation to what a strange and dishonest character she is, went in for an appropriately weird lie. She falsely claimed the bill would "offer contraception like condoms to little kids." It does no such thing, though I have a lot more questions for Britt about how she thinks puberty works, and if it's induced by the sight of condoms instead of the natural process of growing up. 

Dishonest actors like Cornyn are being empowered by Trump, whose lies are even more hamfisted. Trump was recently asked by a reporter if he plans to restrict birth control and he simply said, "Some states are going to have different policy than others." Journalists know this is his way of avoiding a straight answer while letting the religious right know he supports any law they pass. Trump's campaign staff, clearly panicked that he'd let his anti-contraception stance slip, immediately took to Truth Social to claim he had "NEVER" and would "NEVER" support restrictions on birth control. This, however, is a blatant lie. During his time in the White House, Trump passed policies to cut off contraception coverage on health insurance, appointed health advisors who would like to see most methods banned completely, and ended federal funding for birth control at about 1,000 family planning clinics. 

Republicans use two big, interlocking lies to conceal an anti-contraception agenda from the public. First, they deny they intend to take birth control away, by limiting their definition of "birth control" to condoms and the rhythm method. To justify that shell game, they lie about how the most popular and effective forms of birth control work, claiming they are "abortion." They ping-pong between these two lies, so that the fact-checkers can never keep up. 

[...] So many lies in such a short sentence! Plan B is not an abortion. As the Washington Post noted, "Emergency contraceptive pills such as Plan B and Ella work by inhibiting or delaying ovulation, thereby preventing sperm from fertilizing the egg." The second lie is her implication that if folks "consider" something to be true, that makes it the equivalent of a fact. But many people also "consider" the Earth to be flat or believe Ernst is a hobgoblin in a lady suit. Doesn't make it true! Then there's the dishonesty of focusing only on Plan B, which is a drug stigmatized because it's taken after intercourse. What Ernst fails to mention, however, is that emergency contraception and the birth control pill are the same drug, just different doses. They work identically, by suppressing ovulation. The Christian right opposition to Plan B is a stalking horse for banning all hormonal contraception. Ernst's failure to admit that is a lie by omission. 

The Right To Contraception Act vote in the Senate laid bare the GOP’s hypocrisy on contraception: They seek to wage war on contraception and birth control by deceiving the people, including falsely equating most common forms of birth control and contraception to “abortifacients.”

[jacquesthepigeon]

Fascinating the deep levels of BS involved in health insurance and how companies change pricing for each payor

At my clinic we have a couple of common medications that the patient can buy in cash for 10-25 bucks but when those same meds are dispensed via worker’s comp, their prices suddenly change to 100+

So basically healthcare companies charge depending entirely on whatever agreement they have with the payor instead of having a flat rate cost for each goods and services provided and that just makes the fact that they still charge inflated prices to people without insurance instead of setting up a reasonably equitable system for deciding how much to charge based on factors like income and insurance coverage that much more disgusting

[robinruns]

I've been trying to make this post for a while, but I'm having a tough time making it sound as coherent as I want so I'm just gonna ramble, stream of consciousness styles.

I had my physical today. It went pretty quick, and the scale didn't tell me anything I didn't know. The PA was super on board with getting me a referral to an OB/GYN for a sterilization consult. The scheduling department reached out this afternoon and I got an appointment scheduled for the 26th of this month. I went MyChart afterward and checked but didn't see the doctor as in-network. She just finished her OB/GYN residency with the UW and is now starting with UW Health, and my insurance is like The UW Health affiliated insurance so she SHOULD be in-network, but if I had to guess, she's just not fully in the system yet. I work on that end of the medical world, so to speak, I know how that shit goes. But I did send a message thru MyChart to my insurance regarding the coverage for the procedure (my guess is they cover once the deductible is met, which should be soon) and whether or not the doctor is, or will be in-network. I'm having a hard time getting excited until I know for sure that she will be.

I don't wanna have the procedure done until after my 10k, which would be mid-November. It would make sense for it to be then as well because I'll be recovering from the race then anyway.

I think I will for sure stick with my running coach even during the "off season" because I do want to feel stronger and faster going into next year. Also I don't want to risk her not having an opening next spring lol

Today I had a god awful run, like the humidity was outrageous for the billionth day in a row. And then when I left the office, it was fucking nicer out at 10:30 than it was at 6 AM!! Bullshit!!! But I think after today the temps will be back to more reasonable levels, like mid to upper 70s which is about the extent of what I can tolerate. Plus I have a headache from being in the AC so much, like my stupid sinuses are so dried up. I'm so over it. I hate summer. Blah.

I gotta make my lunches for the rest of the week now. I don't want to, but I should. I know I'll mentally feel better if I do, but god I don't wanna get off this couch. Ugh.

I don't think there's really much else I need to talk about right now. Ok post now.

[kp777]

By Maya Goldman

Axios

Aug. 5, 2024

Conservatives are targeting the hundreds of billions of dollars infederal spending that's led to the highest insured rate in U.S. history — and no program is more in the crosshairs than Medicaid.

Why it matters: The Affordable Care Act expansion of Medicaid for low-income adults helped drive enrollment to nearly 75 million people as of April.

But the safety-net health program now costs more than $800 billion annually, with the federal government footing about 70% of the bill.

State of play: Former President Trump's presidential policy platformis conspicuously silent on Medicaid while he's pledged not to touch Medicare or Social Security.

Still, conservative groups from the Republican Study Committee to the Paragon Health Institute to the Heritage Foundation want to turn Medicaid into block grants, impose work requirements or reduce the federal share of program costs for states where coverage has been extended.

The conservatives' beef: The ACA opened up eligibility for able-bodied, working-age adults and offered states extra money to do so, driving up program costs that are swelling federal deficits.

A playbook from Paragon, co-written by former Trump administration economic adviser Brian Blase, would phase out the 90% federal share of Medicaid costs for the expansion population, giving states the same federal funding for all Medicaid enrollees.

Under the plan, only households below the federal poverty level could still qualify for Medicaid, while those above the poverty level would instead be eligible for tax credits to buy coverage on Affordable Care Act exchanges.

The changes would save the federal government between about $252 billion and $530 billion over eight years, depending on how states respond. But states' costs would increase by at least $110 billion over that time — likely forcing some to pare benefits or enrollment.

The Paragon blueprint is a contrast to Heritage's Project 2025, which would cap the federal Medicaid funding available to states. However, Paragon's document says the think tank will release future briefs examining options to set fixed federal Medicaid rates.

The latest: The Trump campaign remains mum on its plans. As president, Trump backed an ACA repeal bill that called for $880 billion in cuts to Medicaid.

Campaign spokesperson Karoline Leavitt told Axios that Trump wants to "end the financial drain on our health care system and ensure that our country can continue to care for American citizens who rely on Medicaid, Medicare and Social Security."

Reality check: Overhauling Medicaid isn't necessarily a political slam-dunk for Republicans, said Chris Jennings, a Democratic consultant.

Republican candidates not explicitly raising Medicaid cuts "suggests that they're already beginning to get concerned that it may not be easy," he said.

Nearly 9 in 10 Medicaid enrollees said in a recent KFF poll that the program should stay largely the same as it is today. More than 70% of adults overall agreed, including more than half of Republicans surveyed.

North Carolina's adoption of a Medicaid expansion plan last year brought the number of states with expanded programs to 40, making a major overhaul more complicated.

The other side: Medicaid changes floated by conservative think tanks "would have a dramatic effect on beneficiaries' access to health coverage and to needed health care services," Edwin Park, a research professor at Georgetown University's Center for Children and Families, told Axios.

Park called the notion that Paragon's proposal would protect vulnerable Medicaid beneficiaries "preposterous." States that keep Medicaid expansion under the plan would have to cut other parts of the program or other state spending such as education, according to a blog post he co-wrote.

Expanding Medicaid to able-bodied adults earning up to 138% of the poverty level improved access to health care, and has been linked to better health outcomes and better health care system finances.

Meanwhile, Democrats used last week's 59th anniversary of the program to showcase Medicaid as a campaign talking point.

"This November, Medicaid is on the ballot. … That's why we must elect Democrats up and down the ballot and protect Medicare and Medicaid from Republican extremism," Democratic National Committee chair Jaime Harrison said in a statement last week.

[shannendoherty-fans]

Shannen Doherty’s Untimely Death Sparks Important Conversations About Healthcare Access And Equity

By Janice Gassam Asare

Shannen Doherty, the actress best known for her roles in Beverly Hills, 90210 and Charmed has died after a long battle with cancer, at the age of 53. In a 2015 statement to People magazine, the actress revealed her breast cancer diagnosis, stating that she was “undergoing treatment” and that she was suing a firm and its former business manager for causing her to lose her health insurance due to a failure to pay the insurance premiums. According to reports, in a lawsuit Doherty shared that she hired a firm for tax, accounting, and investment services, among other things, and that part of their role was to make her health insurance premium payments to the Screen Actors Guild; Doherty claimed that their failure to make the premium payments in 2014 caused her health insurance to lapse until the re-enrollment period in 2015. When Doherty went in for a checkup in March of 2015, the cancer was discovered, at which time it had spread. In the lawsuit, Doherty indicated that if she had insurance, she would have been able to get the checkup sooner—the cancer would have been discovered, and she could have avoided chemotherapy and a mastectomy.

Under the IRS, actors are often classified as independent contractors, which comes with its own set of challenges. Although it is unclear what Doherty’s situation was, for many independent contractors, obtaining health insurance can be difficult. Trying to get health insurance as an independent contractor can be a costly and convoluted process. A 2020 Actors’ Equity Association survey indicated that “more than 80% of nonunion actors and stage managers in California have been misclassified as independent contractors.” A 2021 research study revealed that self-employment (which is what independent contractors are considered to be) was associated with a higher likelihood of being uninsured.

Doherty’s tragic situation invites a larger conversation about healthcare access and equity in the United States. According to the Center on Budget and Policy Priorities, the Affordable Care Act (ACA), also known as “Obamacare,” was signed into law in 2010 and revolutionized healthcare access in two distinct ways: “creating health insurance marketplaces with federal financial assistance that reduces premiums and deductibles and by allowing states to expand Medicaid to adults with household incomes up to 138 percent of the federal poverty level.” The ACA helped reduce the number of uninsured Americans and expanded healthcare access to those most in need. It also helped close gaps in coverage for different populations, including those with pre-existing health conditions, lower-income individuals, part-time workers, and those from historically excluded and marginalized populations.

Despite strides made through the ACA, healthcare access and equity are still persistent issues, especially within marginalized communities. Research from the Henry J. Kaiser Family Foundation (KFF) examining 2010-2022 data indicated that in 2022, non-elderly American Indian and Alaska Natives (AIAN) and Hispanic people had the greatest uninsured rates (19.1% and 18% respectively). When compared with their white counterparts, Native Hawaiian and Other Pacific Islanders (NHOPI) and Black people also had higher uninsured rates at 12.7% and 10%, respectively. The Commonwealth Fund reported that between 2013 and 2021, “states that expanded Medicaid eligibility had higher rates of insurance coverage and health care access, with smaller disparities between racial/ethnic groups and larger improvements, than states that didn’t expand Medicaid.” It’s important to note that if a Republican president is elected, Project 2025, the far-right policy proposal document, seeks to upend Medicaid as we know it by introducing limits on the amount of time that a person can receive Medicaid.

When peeling back the layers to examine these racial and ethnic differences in more detail, the Brookings Institute noted in 2020 that the refusal of several states to expand Medicaid could be one contributing factor. One 2017 research study found that some underrepresented racial groups were more likely to experience insurance loss than their white counterparts. The study indicated that for Black and Hispanic populations, specific trigger events were more likely, as well as “socioeconomic characteristics” that were linked to more insurance loss and slower insurance gain. The study also noted that in the U.S., health insurance access was associated with employment and and marriage and that Black and Hispanic populations were “disadvantaged in both areas.”

Equity in and access to healthcare is fundamental, but bias is omnipresent. Age bias, for example, is a pervasive issue in breast cancer treatment. Research also indicates that racial bias is a prevalent issue—because the current guidelines in breast cancer screenings are based on white populations, this can lead to a delayed diagnosis for women from non-white communities. Our health is one of our greatest assets and healthcare should be a basic human right, no matter what state or country you live in. As a society, we must ensure that healthcare is available, affordable and accessible to all citizens. After all, how can a country call itself great if so many of its citizens, especially those most marginalized and vulnerable, don’t have access to healthcare?

[cbk1000]

So, just got home from my appointment with my new doc. I gave him the Cliff Notes version of all the issues I've been having for the last few months, and I forgot a copy of the initial iron panel that I had done, unfortunately (I meant to bring it and even left it on my computer so I would remember; how did that work for you, dumbass?) but I remembered my numbers, and as soon as I told him what the results were for my initial iron panel, he immediately said, 'That's low."

I KNOW. PLEASE TELL DR. CRAZY THAT.

Basically, he listened to everything I said, asked relevant questions, asked if I'd had my thyroid levels checked (because thyroid can definitely cause some of these problems), said if necessary in future if there are still issues, we can do a thyroid scan, but let's get an updated iron panel done to see where I'm at and if we can increase my dose, work on the iron deficiency, and then go from there. I asked about iron infusions to speed things up, and he said, "Yeah, definitely, we can see if we can get that covered for you if you want to do that." I said I know insurances are a pain when it comes to coverage and a lot of them won't pay unless your hemoglobin is low, and that I have a health savings account and am able and willing to pay out of pocket, and he was like, "Ok, good."

He also offered to refer me to a hematologist, and I said I had thought of asking my last doctor for that, but he was difficult to work with (understatement of the year) and that I figured an appointment with a hematologist would probably be pretty far out anyway, and I'd prefer to try and get in a lot sooner if possible for an infusion. He said, "Yeah, hematology is always backed up." I did say I had been in touch with a telehealth hematologist about possibly ordering an iron infusion, but thought it would probably be faster to go through a local doctor if it was possible to get it ordered through him, but that's at least an option; he was glad to hear I'd been in touch with a hematologist. He wants to see where I'm currently at with my iron panel (I haven't tested it for six weeks) and then figure out what the best course of treatment is based on my numbers. (If I'm at a certain level, an infusion wouldn't be safe, because I'd risk overload, but considering that in four weeks of supplementing, I went up nine points, and then in another four weeks, I went down a point, I'm gonna' be extremely shocked if he comes back like, "Yeah, your ferritin went up to 150, so we can't do an infusion right now."

He actually even brought up POTS and said some of my cardiac symptoms were similar, and I said, "Yeah, I had thought of that, but my heart rate isn't really consistent." He asked if I meant that it wasn't going up when I changed positions, and I said, "Well, it's been coming down as I've been supplementing, and I don't think it would do that if it were POTS. Also, my normal resting heart rate is in the 60s, and on bad days, just lying down in bed, not doing anything, my heart rate is in the 90s. It goes up higher the more I exert myself, obviously, but even lying down doing nothing it's a lot higher than my normal resting heart rate."

I told my previous doctor all of this, and he just ignored all of it and continued to blather on about how the shot had given me POTS.

Do you know what this doctor did? He said, "Oh, yeah, probably not POTS then. Also, if cardiology already checked you out and they didn't even mention it as a possibility, it's probably not."

He also asked if I had a history of iron deficiency anemia, and I said I hadn't had labwork done at the time so I didn't know what my iron levels were or if my hemoglobin was abnormal, but many years ago after a blood donation I started feeling really sick, had the high heart rate and shortness of breath and could barely get off the couch, and I was still living at home at the time, and my mom was a nurse and just put me on iron supplements and that resolved my symptoms, and that those cardiac problems seem to just be how my body responds to low iron.

And he just. Took that at face value. Like, ok, you have a history of this, then, let's work on getting it sorted out and then look at other possibilities if it doesn't all clear up with iron treatment.

So I'm getting my iron panel done Friday, and then we'll go from there with treatment options.

[mariacallous]

Senate Republicans voted Thursday to block a bill put forward by Democrats that would guarantee access to in vitro fertilization nationwide.

The legislation failed to advance in a procedural vote by a tally of 48-47. It needed 60 votes to advance. Republicans criticized the Democrat-led legislation as unnecessary overreach and a political show vote.

“Why should we vote for a bill that fixes a non-existent problem? There’s not a problem. There’s no restrictions on IVF, nor should there be,” Republican Sen. John Cornyn of Texas, told reporters.

The vote is part of a broader push by Senate Democrats to draw a contrast with Republicans over reproductive health care in the run up to the November elections. Democrats are highlighting the issue this month, which marks the two-year anniversary of the Supreme Court’s decision to overturn Roe v. Wade.

Senate Majority Leader Chuck Schumer slammed Republicans who voted against the bill, saying that they are being “pushed by the MAGA hard right.”

“These are the very same people who pushed to get rid of Roe in the Dobbs decision,” Schumer told CNN’s Erin Burnett on “OutFront” Thursday evening, referring to the blockbuster 2022 Supreme Court decision that overturned a constitutional right to abortion. “We know what they’re up to. They want to get rid of IVF, they’re afraid to say it.”

Biden attacked Senate Republicans after the vote.

“Once again, Senate Republicans refused to protect access to fertility treatments for women who are desperately trying to get pregnant,” Biden said in a written statement. “And just last week, Senate Republicans blocked nationwide protections for birth control. The disregard for a woman’s right to make these decisions for herself and her family is outrageous and unacceptable.”

Republicans have criticized the Democrat-led legislation as unnecessary overreach and a political show vote.

The legislation the Senate will take up – the Right to IVF Act – would enshrine into federal law a right for individuals to receive IVF treatment as well as for doctors to provide treatment, which would override any attempt at the state level to restrict access.

The bill seeks to make IVF treatment more affordable by mandating coverage for fertility treatments under employer-sponsored insurance and certain public insurance plans. It would also expand coverage of fertility treatments, including IVF, under US military service members and veterans’ health care.

The IVF legislative package was introduced by Democratic Sens. Patty Murray of Washington state, Tammy Duckworth of Illinois and Cory Booker of New Jersey.

The vote comes after Alabama’s Supreme Court said, in a first-of-its-kind ruling earlier this year, that frozen embryos are children and those who destroy them can be held liable for wrongful death – a decision that reproductive rights advocates warned could have a chilling effect on infertility treatments.

While the state’s legislature took action aimed at protecting IVF in the wake of the ruling, Democrats argue that this is only one example of how access to reproductive health care is under threat across the nation.

Southern Baptist delegates, for instance, expressed alarm Wednesday over the way in vitro fertilization is routinely being practiced, approving a resolution lamenting that the creation of surplus frozen embryos often results in “destruction of embryonic human life.”

The IVF vote is the latest move by Democrats to bring up a bill expected to be blocked by Republicans. Last week, Senate Republicans voted to block a Democrat-led bill that would guarantee access to contraception.

Most Republicans dismissed the effort as a political messaging vote that was unnecessary and overly broad, though GOP Sens. Lisa Murkowski of Alaska and Susan Collins of Maine crossed over to vote with Democrats in favor of advancing the bill.

Republicans have introduced their own bills on IVF and contraception. GOP Sens. Katie Britt of Alabama and Ted Cruz of Texas have introduced a bill called the IVF Protection Act and Republican Sen. Joni Ernst of Iowa has put forward a separate bill to promote access to contraception.

Cruz and Britt attempted to pass their IVF legislation on the Senate floor Wednesday through a unanimous consent request, but Democrats blocked the effort.

Murray, who objected to the request, criticized the GOP bill, arguing that states could “enact burdensome and unnecessary requirements and create the kind of legal uncertainty and risk that would force clinics to once again close their doors.”

Under the IVF bill from Britt and Cruz, states would not be eligible for Medicaid funding if they prohibit access to IVF, but the legislation “permits states to implement health and safety standards regarding the practice of IVF,” according to a press release.

[fandomtrumpshate]

2024 Supported org: In Our Own Voice - National Black Women's Reproductive Justice Agenda

In June of 2022, the US Supreme Court overturned the federally-protected right to an abortion. This decision was followed by a wave of “trigger laws” at the state level, rendering abortion illegal in certain states as soon as that federal protection disappeared. Abortion is currently illegal in 14 US states -- home to over 81 million people -- and significantly restricted in 11 others. Now more than ever, many US residents face near-insurmountable obstacles to making this fundamental choice about their own bodies and futures.

In Our Own Voice fights to secure Reproductive Justice for all Black women, girls, and gender-expansive people. In coordination with state partners, IOOV works with key decision makers to shape public policy to address the many interconnected issues and the unique reproductive health concerns of Black women. Those include the right to health care, dignified birth, and access to abortion care; equity in housing and education; fair employment and clean water; and the full range of social, economic, political, and cultural supports needed for Black women and families to thrive. They strive to assure civil and human rights are accessible to everyone.

In Our Own Voice: National Black Women’s Reproductive Justice Agenda believes that abortion services are part of a continuum of reproductive health care that all women should have access to as basic health care. In their poll, 76 percent of respondents agreed with the statement “health insurance should cover abortion to ensure that when a woman needs to end her pregnancy she will be able to seek a licensed, quality health care provider.”

They work to restore public insurance coverage so that every woman – regardless of income – can access affordable and safe abortion care when she needs it.

You can support In Our Own Voice as a creator in the 2024 FTH auction (or as a bidder, when the time comes to donate for the auctions you’ve won.)

[theculturedmarxist]

What would the world look like if the pandemic never ended, if Covid was causing widespread, long-term illness, and if all this was being covered up by the government?

You might expect to see record levels of sickness and disability. You might expect to see hard evidence that the ‘herd immunity’ plan failed, with children continuing to die at staggering rates. You might expect record numbers of absences in schools and workplaces, tons of canceled concerts and airline flights, more sudden/unexplained deaths in all age groups, and a rise in opportunistic infections (caused by damaged immune systems), like fungal infections or strep A. There would be a coordinated effort to hide data from the public to obscure the truth of the threat. Hospitalizations, cases, and transmission numbers would all be hidden or manipulated. The government probably wouldn’t try to hide the data all at once, because it would be easier to dismantle reporting over the course of several months or years.

Eventually, updates might cease altogether (despite rising cases). The CDC would likely have to hide death data as well. Powerful people with vested interests in keeping the economy running would probably engage in astroturfing online, spreading misinformation to convince the public the threat has passed (to get people back to work and boost corporate profits). The rich and powerful would continue to take precautions, while telling you everything’s fine. This would take a lot of effort, and there would have to be a pretty carefully-coordinated campaign to confuse (and wear down) the public. They might tell you repeatedly how much you shouldn’t be panicking. Hospitals might prioritize a sense of “normalcy” over infection control, so as not to be held (legally and financially) responsible for their role in the unfolding disaster.

The ruling class (who would have access to the truth of the situation) would use their knowledge of what’s coming to invest in long-term care facilities, nursing homes, disability services, and hospices. Some people would obviously figure out what’s going on (like scientists, for example) and start shouting about it from the rooftops. So you’d probably see extreme censorship measures happening on social media sites. As conditions worsen, government officials might start preparing the public to accept mass death, reassuring us that it will only happen to the ‘vulnerable.' Life insurance companies would take note and move accordingly, denying coverage to people suffering from Long Covid. Meanwhile, the scientific evidence would keep mounting.

We are still in a pandemic.

The pandemic is not over. Basically everything you have been led to believe about the virus is a lie. Covid is more dangerous, more transmissible, and more out of control than everyone in power is telling you. We are not back to normal. We are in freefall.

We were lied to at every step of the way. First we were told not to panic and to stay six feet apart. We were told not to panic, ordered by the surgeon general not to buy up face masks, which we were assured we wouldn’t need. Then, we were told to only wear masks if sick or caring for someone with symptoms. When we were all finally told to wear masks in April 2020, we were given bad information about which masks could keep us safe. Cloth and surgical masks do not protect against aerosols (respirators do). And we were told by the people in power these flimsy masks would keep us safe. This was a lie.

The lies that killed us

Documents show that the World Health Organization knew from the start that SARS-Cov-2 was airborne.  They knew that “[a]irflow and ventilation were identified as important factors influencing efficient spread in hospitals,” but did not provide ventilation guidance to the public for years. Instead, this information was withheld from the public; they told the world that Covid spread through droplet transmission and repeatedly insisted Covid was not airborne. Because WHO withheld this crucial information, people around the world did not take necessary airborne precautions, like wearing respirators instead of baggy surgical masks.

Images from the World Health Organization’s publications acknowledging airborne transmission of SARS, juxtaposed with their guidance to the public in 2020. Compiled by Maarten De Cock (@mdc_martinus) on Twitter.

When the vaccines were first made available in late 2020, many leaders and prominent experts told people that the shots would prevent transmission entirely. This was never true; vaccines provide some protection, but don’t stop transmission (and only slightly reduce your risk of Long Covid). Americans were told by the president that they had a choice: “vaxxed or masked,” leading many vaccinated people to stop masking.

Throughout 2021, Americans were told repeatedly that Covid was only a threat to the unvaccinated. The CDC confidently asserted through December 2021 that “Cases of reinfection with COVID-19 have been reported, but remain rare.” While they were pushing this claim, the CDC was conveniently no longer reporting vaccination status alongside information on Covid deaths. (That information would remain hidden until April of 2022).

Once vaccinated people were getting sick with Covid in large numbers and the data could no longer be fully suppressed, the government told everyone that a vaccine plus a breakthrough infection would give you hybrid immunity. Experts declared that this form of ‘immunity’ would be the ticket to ending the pandemic. Then Omicron happened and cases skyrocketed.

The lies continued from there. We were told Omicron was somehow ‘milder,’ we were told that because nearly everyone got it, that we would finally reach population-level ‘immunity.’

But viruses do not automatically evolve to become milder. And Covid did not become milder; it became more insidious, more contagious, and more immune evasive. We now know it is neuroinvasive (even in cases with ‘mild’ acute symptoms), vascular, mass disabling, and far deadlier than what official totals have led us to believe. We know now that most transmission happens asymptomatically, and that reinfections are even more dangerous than initial infections. We know that at least one in ten infections leads to Long Covid, a debilitating neurological disease with no cure. We know this virus dysregulates immune systems, destroys T cells, and directly infects arteries in the heart. And as a result of all of this, we’re seeing unprecedented levels of sickness on a global scale.

We are living through an ongoing democide, being covered up in real time.

Hiding the bodies

The people in power have used every tool at their disposal to downplay, lie about, and cover up the truth of this pandemic. As the cases continued to rise (despite their assurances that things were under control), the US government took even greater steps to keep the public calm and unaware. They changed the way they calculated and shared information about community transmission, changing the scary-looking red map from a comforting green one overnight. The number of cases didn’t go down. But the green map gave people a false sense of belief that things were improving. The CDC called the new map system the Community Levels map. Most people mistakenly thought low Community Levels meant low community transmission, but this confusing system relied on hospitalizations, a lagging indicator.

After, and before. The mostly-green map on the left is dated March 10, 2022 and the map on the right is dated March 9, 2022.

In addition to changing the map, the CDC also made major changes to the ways that Covid cases, hospitalizations, and deaths were tracked. The changes always served to ensure that totals were undercounted. The CDC was manipulating the data, sweeping bodies under the rug. But these changes were made gradually and largely without the public’s awareness. In January 2022, they moved to end daily Covid death reporting by hospitals; by February, they had officially done so. By March 2022, some US states started shutting down daily Covid death reporting altogether.

What the public did eventually hear via the news was that the numbers were trending down. ‘Hospitalizations are down,’ the news told everyone—neglecting to inform all of us of the changes the CDC made to its reporting that artificially deflated these totals in multiple ways.

Hiding the data was not enough to get everyone to accept continued, repeated infections. The government wanted all of us to believe that catching Covid repeatedly was unavoidable and the acceptable cost of keeping everything running. If people were able to avoid becoming repeatedly infected, this lie wouldn’t hold. So they changed the guidance for schools, saying that there was no longer a need for masks, testing, or quarantines. They changed the isolation guidelines so that infectious people were sent back to work after just five days (down from ten)—at the request of the CEO of Delta Airlines. They ended the mask mandates in healthcare and transportation. Allowing people longer absences from work would set a precedent for workers demanding regular sick leave; it was crucial to not let ten-day absences become the norm or the expectation.

Testing moved to the private market, and fewer and fewer people retained the ability to test themselves regularly. And the people who are testing are largely relying on at-home rapid tests—whose results are not being reported anywhere.

On top of all of this, the CDC director called masks the “scarlet letter” of the pandemic. Over and over, the messaging from leadership stated that masks were a burden, masks marked you as an outsider, masks were outdated. They created immense social pressure for people to stop masking. As long as people continued to wear masks in public spaces, the threat remained visible and on others’ minds. Pushing everyone to drop their masks was big business’s way of ensuring people believed the pandemic was over so that they would resume traveling, spending money, and stimulating the economy without reservations.

In August of this year, just three months after ending the global public health emergency, the World Health Organization went as far as to stop sharing Covid-19 Epidemiological Updates. When announcing this change, they stated that “reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally.”

Now, wastewater data is the only accurate data we have left. This data shows the concentration of Covid in sewage wastewater samples from across the country (the virus is shed in our poop when we get sick). And this crucial data is also under threat. Biobot Analytics, the company that provided much of the US wastewater data, lost its contract with CDC NWSS this month. The new contract went to Verily, a company owned by Alphabet (Google’s parent company). The switch is leading to data gaps, as well as changes in sample processing and analysis that will make data from some sites no longer directly comparable with the sites covered by Biobot. Others have noted that, unlike Biobot, Verily offers “little in terms of comprehensible data in regional or national terms.”

Without accurate data on current cases, transmission rates, hospitalizations, and deaths, we have no way of knowing the full scope of the current crisis. Our house is on fire; alarms removed, the public sleeps.

Government mitigations

The government knows that the pandemic is not over. The US Department of Defense is investing in state-of-the-art wearables that can predict if wearers are getting sick. The devices use biometrics and predictive algorithms (trained on hospital-acquired data) to detect infectious diseases up to 48 hours before any symptoms appear. The wearables are part of the Rapid Assessment of Threat Exposure (RATE) project, which recently got $10 million worth of additional funds.  

Everyone who meets with President Joe Biden is PCR tested beforehand.

White House Press Secretary Karine Jean-Pierre recently confirmed that strict COVID-19 testing protocols remain in place, saying, "Anybody who meets with the president does indeed get tested." White House interns still have to agree to wear masks when asked.

When Biden gave a maskless speech last year at Richard Montgomery High School during a period of high Covid transmission, gym windows were removed to rig a temporary high-end ventilation setup. Parents at the school were outraged, and teachers took to Twitter to share photos of the air handling units. NALTIC Industrials called the setup “unprecedented.” Meanwhile, the US government continued to insist on the safety of America’s schools, telling parents to send their kids maskless to poorly-ventilated classrooms.

[gumjrop]

The Weather

While not in the US, an article from CBC News in Canada offers a look into the upcoming respiratory illness season. Data from Internal Alberta Health Services shows that patients hospitalized with COVID passed 900 and “roughly doubled” in a month. Accurate data are hard to find, however, as the provincial government changed how COVID statistics are reported. Cameron Westhead, second vice-president with United Nurses of Alberta, commented, “This government likes to talk about personal responsibility and making decisions that are best for yourself and your family. But we don’t have the data to make those kinds of decisions.” In addition, an outbreak in the community has the potential to overwhelm hospital systems again. Isolation requirements, PPE needs, and healthcare worker burnout are all major concerns with COVID patients. Rather than stripping healthcare of the precautions we need to control the ongoing pandemic, we must advocate for more support for healthcare workers, masks in healthcare, and acknowledgment of the severity of COVID infections.

Wastewater

We continue to wait for Verily, the organization taking over the National Wastewater Surveillance System (NWSS) contract from Biobot, to provide a readable Nationwide representation of the current wastewater levels. According to WastewaterSCAN, COVID wastewater concentration is medium nationally, apart from high levels in the Northeast. As of October 16, 2023, the national average of wastewater levels is 216.9 PMMoV Normalized. Regionally, the Midwest is 317.0 PMMoV Normalized, the Northeast is 589.82 PMMoV Normalized, the South is 152.3 PMMoV Normalized, and the West is 164.7 PMMoV Normalized. We emphasize that Wastewater SCAN has fewer wastewater sites represented as compared to Biobot. Combined with some other caveats, including the difficulty of interpreting their plots, we remain skeptical of Wastewater SCAN’s data.

The above graphic shows the overall trend for the United States. The y-axis is a scale for the quantity of nucleic acids, PMMoV Normalized (x1 million). While concentrations have been trending downward–with a possible recent uptick–we urge the importance of layers of protection. As the Northern Hemisphere enters winter and many folks celebrate holidays, please protect yourself and others with masking, distancing, clean air, vaccines, and other layers of protection. For more on layers of protection, refer to this writeup on PeoplesCDC.org.

Vaccines

NPR reports that parents are finding it difficult to find pediatric doses of the new COVID vaccines for their children. The CDC reports that pediatric doses are available, but several factors are limiting their spread. Faulty websites or outdated information from public and private organizations, shipping delays or errors in the number of doses shipped, and issues with public and private insurance all contribute to a lackadaisical approach to public health. Parents are frustrated at the situation and scared for their kids, especially as we enter flu season. We hope that if you haven’t been able to receive an updated 2023-2024 COVID vaccine, you are able to access a dose soon. If you have questions about insurance coverage, visit the KFF information page here. For children covered under state insurance, see information about the Vaccines for Children program. Uninsured adults may receive assistance through the Bridge Access Program. Please note not every pharmacy or clinic participates in this important program.

Long COVID

An article from the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP) argues that Long COVID studies in children are lacking. Estimates of prevalence of Long COVID in children range from 1% to 70%. Children may have different experiences with Long COVID from adults, as well as having limited vocabulary to describe their symptoms. Poor study design also contributes to artificially low numbers. Hannah Davis, co-founder of the Patient-Led Research Collaborative, suggests that further studies could use a prepandemic cohort or electronic health record data to serve as controls rather than a cohort defined by negative PCR tests, which could contain false negatives. Additionally, more longitudinal studies are needed. The article highlights a huge range of uncertainty reflecting a lack of research. Children with Long COVID deserve recognition, care, and support.

Take Action

Reminder to either submit a written comment or register to give an oral comment to the CDC’s HICPAC meeting on November 2-3, 2023. National Nurses United provided some guidance on talking points one can use during the oral comments. You can submit written comments to HICPAC@CDC.GOV starting November 1, 2023, with the deadline at 11:59 pm on November 6, 2023. To request time for an oral comment during the webcast, submit your request to the oral comment submission form no later than 11:59 p.m., EST, October 23, 2023.  As the CDC is poised to weaken protections for patients and healthcare workers, please sign on with National Nurses United and demand the CDC be transparent. At the link, you can fill out a form to send an email to CDC/HICPAC leaders that emphasizes the need to post the updated guidelines in full for public review, make meetings and comments open to the public, and use a science-based approach to aerosol transmission.

Notes: 1) The numbers in this report were current as of 10/20/2023. 2) Changes in testing access as well as data reporting have led many federal data sources to become less reliable. 3) Wastewater data are being sourced from WastewaterSCAN and no longer from BioBot due to the end of the contract with the CDC. 3) Check out the links throughout & see our website for more!

[phoenixfire-thewizardgoddess]

So, fun little fact of having everything destroyed by fire in a rental, by an appliance that you didn't use but was hardwired into the place by the owner of the place... it doesn't matter it wasn't your fault.

Just got told I now have to get everything out of the place as soon as possible to allow the owner to start fixing the place up again

For one, the place is fucking decimated (just like my life because it destroyed 90% of my things and, oh yes, murdered my beloved kitten who was my little duckling, my shadow, my daughter)

so how exactly is anyone going to fix it up given the windows blew out, the roof is annihilated (fire went straight up and across so fast it melted the smoke alarms off before they turned on), and the floor in at least one room is destroyed

the HEAT of it all, actually destroyed things deep inside wardrobes and thick chests of drawers, the structural integrity of the place feels akin to a prawn cracker. clothes in those items of furniture were annihilated.

I am truly grateful kitten passed in her sleep to smoke inhalation and wasn't burned, because the sheer scale of decimation around her was pretty severe but she shouldn't have been in that position at all

still trying to get hold of the damn report on the fire by the investigators, because the cause is clear but what triggered it isn't.

also found my cameras (security) in the kitchen had been turned to face nothing for at least a week prior. that's super weird because it was motion activated and tilted itself in the direction of motion, very confused about this... I didn't notice because the app notifications weren't pinging as motion triggered. ??????? It melted, but I have some stuff on the app, super confused about that whole thing.

turns out contents insurance would have allowed for specialist removalists to gut the place, but (surprise) couldn't get that given that there were no deadbolts on the place.

just being in there with masks on, and a respirator borrowed from family, after the fire was enough to have you hacking and eyes streaming. I am honestly concerned about safety of moving things without like full body coverage

whoever I can get to do it won't be cheap

also, rural area... so, that also absolutely is going to limit who and how much.

not that I am not exceptionally grateful in the generosity shown by people in my life. my workplace found and contracted a new unit , everyone brought furniture or items, or bought me kitchenware. I was able to live with family while everything was devastating, and they are continued support. I had a small bit of clothes and a metric fuckload of books at another family household, so it wasn't everything everything and I had help to arrange baby's cremation, return to work, etc.

i am better off than many, many others in this situation.

but it feels like it's now Over, and Dealt with. But I'm still angry that it happened, and I miss my little girl. Work is kind of being difficult at the moment because there were things that went by the wayside when I had to work remotely from another office, which is coming back to bite me.

Sometimes you just don't sleep because there's a lot going on in your head... and you're a bit late, and even if you are there hours after close of business to finish things in order to manage expectations, it doesn't count. you can't be late. they do little meetings about it threatening support plans or to sign you over to the mental health team, which is a great support for those who need it but I find them meddlesome and they treat people like they're made of glass. which is counterintuitive to getting people back on equal footing if you feel me.

There's so many shitty little things, and you feel ungrateful, because again... who else has this level of support and grace provided after a tragedy? Who has family just pay for things upfrnt with a 'pay it back overtime when you can, without killing yourself' response to trying to make a payment plan with them

who has a mattress and chairs and a little tv and a table and chairs provided, who had an entire office check their houses and sheds for furniture you could have? who else had people begging to know what you needed and bringing sheets and towels and bowls, cups, cutlery to make sure your new house wasn't empty? they even gave me a gift card from a whip round for those who didn't know how to help but wanted to give money to allow me to get what i needed when things weren't a nightmare

like, the generosity and aussie care has been amazing.

but im still sad, and angry and frustrated about all the other little things.because this still did happen, and my little girl is gone, and there are no answers or accountability for it at all.

and every time you think you can move forwards, some new issue or task arises. people mean well when they ask if you will get a new cat, if you are speaking to a professional... but sometimes that misses the mark in a way they didn't mean with their well-intentions.

Zarya will never be replaced, and she should never be. Talking to someone won't fix the fact that unfortunately life and being an adult means that you have to keep moving forwards even when you are tired and angry and frustrated, because bad things do happen all throughout your existence. its a sucktacular part of life.

and then you think, people are having a much worse time all over the world right this second. you have a house, you are inside in the cold, no one is mistreating you, you aren't living in fear that the next silence or whistling means death from above... people are having horrific times, and this is sad and awful but nowhere on that scale.

it's easy to get in your head about this stuff, but that's the worst thing you can do. we can't change the past, no matter how much you'd love five minutes with the TARDIS, we can only go forwards... and part of that is finding a new normal no matter how much it sucks that you didn't choose to forgo the previous status quo

have i listened to hazbon hotel's soundtrack so often i can sing the songs off by heart (also helluva boss) as a coping mechanism? sure. do i have so many half done craft items around it's almost disguting because hands and brain need to be Busy? also sure. am i also grumblingly doing work and household chores and bitching to family about mundane shit and visiting friends and their furbabies on occasion? also yeah.

Its so easy to lay down and just feel grief and nothingness. There is also nothing wrong with that, you get fucked up thoughts like 'Kitten chose me as her mum and i fucking killed her by trusting that unit was safe', and you can't let that get a hold of your brain or you just dissolve. There was no way to even consider this would happen, r that she would be less safe that day than any other day she'd lived there, etc.

Keeping moving is the key, not like running or anything. Meander along with life, until it feels like you can breathe... and when shitty little reminders like the one i was initially ranting about come up, there's no shame in some angry mental pacing and blustering as the emtions surge back through, as raw as the day it happened. You will keep going aggain soon, but its not a race.

Life sucks sometimes, and it's not okay... but that's okay.

[justinspoliticalcorner]

Erin Reed at Erin In The Morning:

On Monday, the 11th Circuit Court of Appeals ruled that transgender health insurance exclusions violate Title VII of the Civil Rights Act. The case was brought by a transgender employee of the Houston County Sheriff's Office in Georgia who was denied coverage for gender-affirming surgery. The employee sued in 2019, and after a protracted lawsuit, won at the district court level. Now, with this 11th Circuit Court ruling in favor of transgender employees, a significant precedent is building to protect transgender employees against health insurance restrictions that deny them the ability to get gender-affirming care.

The employee in question first transitioned in 2017. After informing Sheriff Cullen Talton at the Houston County Sheriff’s Office of her decision to transition, she was told that he “does not believe in” being transgender, but that she would be allowed to keep her job. However, when it came time to obtain gender-affirming surgery, significant controversy erupted: her claims were denied. When she filed a lawsuit to have her surgery covered, the sheriff's office and county fought against her right to equitable health care coverage. Since then, the county has spent incredible amounts of money denying the plaintiff her care. As of 2023, Houston County, Georgia, had spent $1,188,701 fighting against providing health care coverage for the transgender plaintiff. This is significant: ProPublica reports that it is over three times the county’s annual physical and mental health budget. Importantly, no other employee has requested coverage for gender-affirming surgery, so fighting against coverage has significantly cost the county far more than it would have gained by simply providing the employee with that coverage.

Ultimately, a lower court ruled in her favor, stating that such exclusions violate Title VII of the Civil Rights Act. In the decision, the judge stated, “the implication of Bostock is clear… discrimination on the basis of transgender status is discrimination on the basis of sex and is a violation of Title VII.” The judge then ruled that the exclusion was facially discriminatory and violates Title VII. In doing so, he ordered that the county must drop such exclusions. The plaintiff was also awarded $60,000 following the ruling.

[...]

In making its decision, the court referenced two recent developments that may change the legal landscape for transgender people. In one footnote, the court mentioned Kadel v. Folwell, a case just decided in the 4th Circuit Court of Appeals, with the court ruling that discrimination against transgender health care violates the Equal Protection Clause. Though it does not reference the case elsewhere, the 11th Circuit used similar legal arguments: that you cannot circumvent discrimination cases by discriminating by proxy. In this case, like in the Kadel case, the judge ruled that discriminating against transgender health care is also discriminating against transgender status. The judge ruled that the defendant’s “sex is inextricably tied to the denial of coverage for gender-affirming surgery,” and thus, one cannot circumvent discrimination statutes by claiming they are only discriminating against a procedure and not a category of people.

The court also referenced new Title VII guidance from the Biden administration in a footnote when making its decision that exclusions violate those regulations. On April 29, the U.S. Equal Employment Opportunity Commission issued updated guidance stating that Title VII protections include protections on gender identity. 

[...] The ruling is significant and will likely be one of the many rulings referenced whenever such cases eventually reach the Supreme Court. Multiple courts have ruled in favor of transgender people and their health care, but some significant courts, including in a recent decision by the 11th Circuit Court on health care for transgender youth, have ruled against such legal protections. It is likely that this decision will be cited favorably in many other court cases in the coming months.

The 11th Circuit Court ruled in Lange v. Houston County that trans health care exclusions violate Title VII of the Civil Rights Act.