We talked with Amanda Ptashkin, Outreach and Advocacy Director with Georgians for a Healthy Future and Em Elliot, Field Organizer with Georgia Equality to discuss their collaboration, and what they expect to see over the next year, especially as enrollment begins, and their state’s fight to expand Medicaid continues. Georgia is a politically conservative state with a large LGBT population, so the partnership described below can serve as a model and provide lessons to other states who are working to engage LGBT populations in their Medicaid and outreach and enrollment campaigns.
Community Catalyst (CC): Can you give us a bit of background on Georgia’s LGBT population?
Em: As you can see on this map, there are LGBT individuals living in every corner of the state and not just concentrated in the Atlanta area like some may think. The Movement Advancement Project estimates that LGBT people in Georgia account for 3.5 percent of the state’s population.
CC: How was the partnership between Georgians for a Healthy Future and Georgia Equality initiated?
Amanda: Georgia Equality’s executive director, Jeff Graham, is one of the founding members of Georgians for a Healthy Future, so the relationship between the two organizations has been strong since Georgians for a Healthy Future’s beginning. When the Affordable Care Act (ACA) first passed, we worked together to present educational programs for the HIV community, and last year we started exploring ways to include more of the LGBT community in Medicaid expansion and outreach and enrollment campaigns.
CC: What’s been the focus of your collaborative work? How did you decide this?
Em: Much of our work over the past few months has focused on engaging the LGBT community and the HIV/AIDS community in advocacy efforts to expand Medicaid in Georgia. Intentionally leaving more than half a million Georgians uninsured is bad public policy and does not make economic sense. This is an issue of basic human rights, economic justice and good public health.
CC: Why is the Medicaid expansion an important issue for Georgia’s LGBT population?
Em: LGBT folks are more likely to face health disparities and stigma within our health care system, making access to culturally-competent care more difficult. LGBT people are more likely to be uninsured or low-income than their straight or cisgender peers, so there is a great need for health services and access in general. More than 65 percent of the LGBT Georgians who accessed an LGBT Health Fund for the uninsured in 2011 were folks who would be eligible for Medicaid if Georgia took up the new expansion.
Due to non-discrimination rules in the ACA, plans have to provide preventive screenings for everyone who needs them at no additional cost, regardless of the sex on their insurance card, which is important for transgender and gender non-conforming folks. Same sex couples will also benefit as a new Healthcare.gov tool will allow individuals to find same-sex domestic partner coverage options. Expansion has big benefits for people living with HIV as well. Up to 72 percentof people living with HIV/AIDS in Georgia would qualify for Medicaid.
CC: What Medicaid expansion messaging has resonated well with GA’s LGBT communities?
Em: Talking about Medicaid expansion with the LGBT community has been very interesting. We have to spend time just educating our community on what is at stake; often LGBT folks do not think this expansion would include them because they have been excluded from comprehensive health coverage in the past. We had to do a lot of basic myth-busting and general education. More specifically, we created messaging for LGBT youth, many of whom cannot remain on a parent’s insurance because of strained relationships, for single people or couples who do not have access to domestic partner benefits, and for those members of the LGBT community who are either self-employed or who work in industries that do not usually offer health insurance, and for people who are living with HIV/AIDS.
CC: What have been some unexpected surprises (both challenges and assets) to working with a statewide consumer health advocacy group?
Em: Because Georgia Equality has already established a working relationship with Georgians for a Health Future, it’s not really a surprise, however, their sensitivity to LGBT issues, flexibility in changing some of their materials to be more inclusive and commitment to include us fully in their work has been such a relief. It’s also been nice that we can focus on our area of expertise while leveraging Georgians for a Health Future’s expertise on more general health policy and ACA implementation. In that way, our work complements each other’s nicely.
CC: Where do you see this collaboration going next?
Amanda: Regardless of when Medicaid is expanded, this collaboration has been a hugely positive one for us, and we hope to see our partnership continue beyond Medicaid expansion. Both groups have expertise in different areas and bring a lot to the table. We hope to harness this team for additional collaborations in the future that would benefit both organizations and create a helpful, ongoing relationship.
Em: For example, once the state decides to expand Medicaid, we will need to leverage the power of Georgians for a Healthy Future and other coalition partners to ensure medical care for transgender individuals is included in the essential health benefits that would be designed as part of future expansion efforts. Additionally, Georgians for a Healthy Future and Georgia Equality are both part of a consortium of organizations that were recently awarded a grant from the U.S. Department of Health and Human Services to work on outreach, education and enrollment into the new health insurance marketplace.
CC: What are some lessons for other states?
Em: Two lessons come to mind that could be helpful for other states:
The first is the need to tailor messaging directly to the LGBT community by using images and examples that are specific to this group. In far too many instances, mainstream organizations wonder why their outreach efforts to the LGBT community fail to generate much response. The LGBT community is so used to being ignored, undervalued or misunderstood that there is a hesitancy to feel included unless that inclusion is direct and visible. The LGBT groups will come if they feel the outreach is genuine and the commitment to our issues is sincere.
The second lesson is that working with the LGBT community should not be seen as controversial. If we can be successful with these efforts in a conservative environment like Georgia, then other mainstream organizations and coalitions can be successful in other parts of the country. There may be a need to do some education with boards of directors or staff to ensure the commitment is solid, but the public’s attitudes on a host of LGBT issues has changed dramatically in the past few years. Hopefully more mainstream groups will begin to appreciate the importance of including us as a community in their educational efforts and advocating for our needs in their policy work.