The House of Representatives recently approved a budget that would require deep cuts to Medicaid. The proposed budget bill is asking the Energy and Commerce Committee to eliminate $880 billion from its budget. There is no way to eliminate this amount of money without deep cuts to Medicaid spending over the next 10 years. This would have dire consequences for the millions of vulnerable communities—including LGBTQ+ patients, people of color, and patients in rural areas—who rely on Medicaid for their health coverage. Many of those who would be most affected are those who gained coverage due to the Affordable Care Act (ACA) Medicaid expansion. It is imperative to protect Medicaid funding so marginalized communities can continue to access the healthcare they need!

Who uses Medicaid?

As of October 2024, almost 80 million people were enrolled in Medicaid and Children’s Health Insurance Programs (CHIP). In Illinois more than 25% of the state’s population relies on Medicaid health insurance to cover medical needs. That’s more than 3.6 million Illinoisans. Medicaid expansion under the ACA allowed an additional 800,000 people in Illinois to be eligible for Medicaid. Medicaid expansion has been particularly beneficial for LGBTQ+ people, people living with HIV, and other marginalized communities. A Center for American Progress survey estimated the LGBTQI+ uninsured rate was 20% in the states refusing to expand Medicaid, compared to 8% in states that adopted Medicaid expansion. A 2020 survey by the Center for American Progress found 52% percent of LGBTQ+ Intersex people were enrolled in Medicaid at the time. Of the estimated 1.2 million LGBTQ people covered by Medicaid, potentially over half a million could lose their Medicaid coverage due to federal Medicaid cuts or policy initiatives such as work requirements.

Medicaid is also a lifeline for those living with HIV. Medicaid is the largest source of insurance coverage for people with HIV in the U.S., covering an estimated 40% of the nonelderly adults with HIV. Medicaid is also a vital source of funding for HIV treatment and prevention. Medicaid accounted for 45% of all federal HIV spending in fiscal year 2022. Medicaid also supports many communities of color gain access to healthcare. Nearly 60% of Medicaid enrollees are people of color.

How could Medicaid funding be cut?

Passing a budget in Congress is a multi-step process. Both chambers of Congress are tasked with creating separate budget resolutions. Proposed funding is divided among 12 subcommittees within each chamber, and each is responsible for funding for different government functions such as healthcare. Once the House and Senate pass their separate budget resolutions, they then must merge them into a single bill and both chambers must pass a single version. The final spending bill passed by the House and Senate is then sent to the President to either be signed or vetoed.  Recently both the House and Senate passed budget resolutions that include the proposed spending cuts of $880 billion. Even with these resolutions, this isn’t the final budget. Both the House and Senate need to combine their separate bills into one single bill. This means there is still time to negotiate how much Medicaid and other healthcare funding could be impacted, including not making Medicaid funding cuts at all.

Potential impact of healthcare cuts

If the final budget includes the proposed healthcare funding cuts, there are several possibilities for how Medicaid spending cuts could impact states and enrollees. These cuts could greatly impact state healthcare budgets. To financially support State’s Medicaid programs, including ACA Medicaid expansion that increased the number of people eligible for Medicaid, the federal government helps supplement the costs. Currently, the federal government pays 90% of the costs for those eligible for the Medicaid under the ACA expansion compared to just over 50% for the core Medicaid population. In many states, including Illinois, if federal funding for Medicaid expansion recipients goes below 90%, a trigger law would automatically end the state’s participation in Medicaid expansion. This would result in lost coverage for around 862,774 or 28% of people enrolled in Medicaid in Illinois.

There are also several other potential policy changes from the federal government could make to reach the desired funding cuts from Medicaid, such as introducing per-capita caps. This would limit the amount of federal spending per Medicaid enrollee, potentially reducing overall spending but shifting cost burdens to states during high-need periods. These per-capita caps would lower the federal payment floor, which would reduce all the federal funding contributions to below 50% for traditional Medicaid enrollees.

Another popular proposal among those who would like to see significant Medicaid funding cuts, and a prominent proposal in Project 2025, is mandatory work requirements for Medicaid eligibility. Work requirements for Medicaid have been shown to be ineffective. Employed adults who rely on Medicaid frequently work in low-wage positions with variable hours which usually do not offer employer-sponsored insurance or affordable coverage. Many times, this means they cannot meet the proposed number of documented work hours needed to stay eligible for Medicaid. Low-income people are also likely to experience other barriers to employment, such as limited access to transportation, lack of internet access, caregiving responsibilities, and chronic health problems. Arkansas enacted work requirements for a brief time in 2018, and more than 18,000 people lost their Medicaid coverage due to barriers such as the job they worked, transportation and the difficult reporting system needed to record work hours.

How will this affect FQHCs

Federally Qualified Health Centers (FQHCs) partly rely on Medicaid payment rates to help fund their services. FQHCs were created to serve the most vulnerable populations and provide care for over 32 million people in the U.S. In 2023, Medicaid accounted for 43% of health center revenue and covered 50% of health center patients, compared to 19% of the overall U.S. population. If a trigger law repeals Medicaid expansion or if Medicaid repayment levels and federal funding are significantly reduced, this would have a devastating impact of FQHCs ability to provide services. The lack of funding would result in a reduction in the healthcare staff, fewer staff means fewer patients being seen. It could reduce or eliminate other services such as mental health services and dental services.

Conclusion Cuts to Medicaid will result in the loss of healthcare coverage for the most vulnerable and gut healthcare safety nets like FQHCs. Any of the proposed policy changes would fundamentally alter how Medicaid financing works and federal spending reductions of this magnitude would put states at significant financial risk. To help protect millions of people’s healthcare and support healthcare centers, you can reach out to your Senators in Congress and tell them to vote no on cuts to Medicaid funding and policy changes that hurt patients and States.

To learn more about how Howard Brown Health contributes to vital advocacy work and has an impact on local, state, and federal policymaking, please visit our Advocacy webpage. To stay up to date with advocacy and policy news like this, sign up for our newsletter.

The Safeguard American Voter Eligibility (SAVE) Act has been reintroduced in the U.S. House of Representatives and will be voted on the in the next few days. This legislation would require potential voters to bring proof of U.S. citizenship in-person when registering to vote or updating voter registration information. Acceptable documentation includes: a REAL ID-compliant driver’s license or government issued photo ID that “indicates the applicant is a citizen,” a valid U.S. passport, a birth certificate, or a military ID card with a military record of service that lists the applicant’s birthplace as in the U.S. Currently, people can provide just their driver’s license or social security number to register to vote.

This will present incredible barriers to voting. Documentation like a passport or birth certificate is much more difficult for many people to attain. More than 140 million American citizens do not possess a passport. For context, just 153 million Americans voted in the 2024 presidential general election. Because the SAVE Act would require many voters to use their passport or birth certificate to verify their identity and citizenship, additional barriers to voting could be created for millions of Americans. For example, people who seek name changes often have different names on government IDs compared to original birth certificates. These discrepancies could result in voter registration being delayed or denied. The SAVE Act is an attempt to disenfranchise millions of voters and will most impact vulnerable communities such as the LGBTQ+ community.

What’s in the SAVE Act?

The SAVE Act looks to create insurmountable barriers to voting, especially for many marginalized and already disenfranchised communities. Under this Act, most voters will no longer be able to register to vote with their driver’s license alone. They would need a passport, birth certificate or an “Enhanced Driver’s License”, which are only available in five states. This is in stark contrast of current federal law where anyone registering to vote can provide either their driver’s license number or the last four digits of their Social Security number to provide election officials with the necessary information to verify their identity and voting eligibility. Election officials are always required to cross refence voter eligibility using federal citizenship data from the U.S. Department of Homeland Security, data from the Social Security Administration, death data, and U.S. Postal Service change-of-address data.

The SAVE Act would affect already registered voters as well. Anytime someone changes their address or changes their pollical party, for example, they would need to arrive in-person with an approved form of documentation to make these minor changes. The insistence on registering and re-registering in-person will effectively eliminate online and mail-in voter registration. During the 2022 midterm elections, of the 1 million Americans who registered to vote or updated their voter registration, only 5.9 percent did so in person. 

How the SAVE Act will Disenfranchise Voters

The SAVE Act would present challenges for many people, but is particularly insidious for LGBTQ+ voters, especially trans, nonbinary, and intersex voters. Many trans people go by a different name than the one they were assigned at birth. However, not all who want to legally change their name are able to do so. The process varies by state but is often complex and time consuming. Trans, nonbinary, and intersex people may also possess IDs or documentation with a photo that isn’t reflective of their current gender identity or expression. Under the SAVE Act, citizenship documents—such as a passport or birth certificate—would have to match a current photo ID. Many trans, nonbinary, or intersex voters may have incongruous gender identity markers on their official documentation. According to the 2015 USTS, only 11% of trans respondents have the name and gender marker they use on all their identification documents.

However, trans people are not the only people who will find it more difficult to vote under the SAVE Act. People who’ve taken their spouse’s name would have more difficulty registering to vote as their names probably won’t match their birth certificate or passport. This will greatly affect married women as 83% of women change their last name when they marry. Disabled people or older adults with mobility issues will have greater difficulty voting without the online or mail-in options. Working people may not be able to take time to register to vote in-person during worktime hours. The bill’s in-person requirement could also disenfranchise approximately 60 million rural voters, who would have to travel great distances to register to vote. Some voters in Hawaii and Alaska might even need to take flights to update their voter registration data to be eligible to vote. Lower income Americans would be dramatically affected. Only 1 in 5 Americans with income below $50,000 have a valid passport. LGBTQ+ people are more likely than their non-LGBTQ+ counterparts to experience poverty and unemployment.

Conclusion

The SAVE Act is bad for a majority of voters and further disenfranchises LGBTQ+ voters. Non-citizens are already prohibited by law from voting in federal elections and this bill will unjustly prevent millions of voters from participating in elections. To ensure everyone’s voting rights are protected, please contact your Representative today and demand that they vote NO on H.R.22. 

To learn more about how Howard Brown Health contributes to vital advocacy work and has an impact on local, state, and federal policymaking, please visit our Advocacy webpage.

50 years ago, Howard Brown Health was founded by four volunteers with a vision to improve the health of their communities. So many years later, our volunteers are still a core part of the work we do every day. In the last year, over 175 individuals and 25 corporate groups have collectively dedicated nearly 6,500 total volunteer hours at Howard Brown locations and over 20 community events to support their neighbors and community members.

National Volunteer Week is celebrated during April every year. It is an opportunity to recognize the impact of volunteer service and the power of volunteers to tackle society’s most significant challenges, build stronger communities, and be a force that transforms the world. Celebrate with us and thank community members like Richard, Lonnie, and Matt for the amazing impact they’ve had over the last year!

If you’re interested in becoming a volunteer yourself, you can learn more at our Volunteer page.

Richard D.

“I moved to Chicago in August 2024 to begin a new chapter in my life. Looking for a primary care provider, I researched Howard Brown Health on the recommendation of a friend and what I found left me with such an appreciation for what the organization does for the LGBTQ+ community and their allies. My life had a lot of changes in a short period of time, and HBH was there to help, so when I saw the Get Involved link on the website I knew this was my opportunity to give back.

Initially, I thought there would be an event here or there – just a few hours a month – but I’ve never been so happy to be mistaken. There are so many opportunities to help, and I’ve made many friends and continue to build my connection to this vast community. The most rewarding thing for me is I know this work is making a difference in people’s lives whether it’s helping patients to check in at the clinic, assisting attendees at the diabetes fair or sorting donations at The Brown Elephant.  I have never felt so much appreciation and camaraderie as I have with Howard Brown, but the difference it is making in the lives of the community is truly what keeps me coming back. 

I am excited to volunteer with Howard Brown’s 50^th Anniversary Gala later this month to help honor our past, present and future!” 

Lonnie K.

“I proudly volunteer at Howard Brown Health because I appreciate the support that was given to me as a transgendered male during my transition.  I believe everyone is entitled to affordable health care and the support of the LGBTQAI+ Community to which I’m a proud member.  I was honored to be chosen to tell my story which was featured in this video that premiered at Dish in 2022 raising more than $350,000 to provide affirming medical and behavioral healthcare, education, outreach, and support services for Chicago’s LGBTQ+ community and its allies.

As a grateful patient, I serve as a member of the Patient Advisory Council, which is composed of Howard Brown Health patients who provide feedback to staff on how the agency can improve its services and work with the lesbian, gay, bisexual, transgender, queer (LGBTQIA+), and HIV+ communities in Chicago.  I have enjoyed volunteering the Howard Brown beer booth at Pride Fest and Market Days to help raise money for LGBTQ+ affirming patient care.  I also liked volunteering at the Trans Media Fashion show because all the money we raised through tickets sales goes to help young LGBTQ+ people using services at Broadway Youth Center.  Marching in the Pride and Bud Billiken Parade were great ways for us to be visible in the community. 

I would encourage others to become Howard Brown volunteers like me.  It’s an honor and privilege to serve my community.  Thank you for the opportunity to serve at Howard Brown Health and Happy 50th Anniversary!”  

Matt K.

“I volunteer with Howard Brown Health because I’m passionate about supporting the LGBTQ+ community and giving back in ways that create lasting impact. Over the past year, I’ve proudly dedicated over 100 hours of service, contributing my time and energy to both the Brown Elephant resale store and special events like the Trans Media Fashion Show.  

At Brown Elephant, I assist with everything from organizing merchandise to helping customers and maintaining a welcoming and inclusive environment. For the TransFashion Show, I helped behind the scenes to ensure the event ran smoothly—an experience that was both meaningful and inspiring.

The work I do as a volunteer is important because it supports vital healthcare and social services for underserved communities. By contributing to Howard Brown’s mission, I’m helping to create safer spaces, raise awareness, and celebrate diversity—all things I deeply believe in.”

Stacey H.

“Growing up, I had two first loves, music and film. It is no secret that I am a HUGE fan of the eighties. Many iconic artists emerged from this era that shaped my view of life, love and more importantly being a woman who owns her words and actions. I choose to devote many hours with Howard Brown Health because it is through the LGBTQ community that created new genres in music and film. Think about it; every time you hear Lady Gaga, watch Evita, listen to Madonna, attend films or listen to house, disco or electronic music, you have the LGBTQ community to thank for celebrating and bringing their experiences to fruition through music and film. Now this community is once again under attack; simply for being so colorful and bright that it burns and enrages our government.

I am no stranger to opportunities to not only create change but to stand up and with my family of the LGBTQ+ communities. My family taught me the value of standing up when it is called into action and that is the kind of world I want to live in. It is for this and many other reasons why I donate my time and energy to those who have given me every reason to celebrate the greatest loves of my life. Without this community, we would not have such an immense range of music or film that inspires and uplifts us. One can choose to be anything, but for me, I prefer to be legit than to stand in a bar pretending that the very music I listen to is not inspired by those who also took a stand, by dancing in bars when their lives were threatened, taken or persecuted, simply for being too bright to dim. I will always dance to the very music I love, in their honor and memory.”

Stacey is a member of Howard Brown’s Vernita Gray Council for Philanthropy which helps further the mission of Howard Brown Health through fundraising, engagement, and outreach.

The General Election is November 5! We want to ensure your Election Day runs as smoothly as possible. We have some resources to consider when planning your Election Day.

First, make sure you are registered to vote. You can register to vote here. You can also check your registration or apply for an absentee ballot. You can also visit the Illinois Board of Elections for more information. If you have any special circumstances to consider when voting such as voting with a disability or voting while experiencing homelessness you can read our rights to accommodations blog.

For our Trans and non-binary voters, Advocates for Trans Equality has a Voting Guide to help you prepare for Election Day. The ACLU Illinois also has a know-your-rights guide to help all voters in Illinois navigate the polls on election day and provide information on how to report any issues while voting.

There are several topics to consider when casting your ballot. To help prepare you for Election Day, we’ve assembled several blogs discussing important topics surrounding the Election, including a blog discussing what Project 2025 is and how Project 2025 could affect your healthcare. There are also blogs on the state of anti-LGBTQ+ legislation in 2024, access to housing, the dire need to increase funding for community health centers like Howard Brown, and the importance of school board elections.

Key Issues This Election

Tell Legislators to Support Reproductive Treatments for LGBTQ+ Families: On your ballot this November there will be a non-binding advisory question regarding insurance coverage for medically assisted reproductive treatments. While this question is not binding, it will serve as a way for Illinois legislators to better understand your needs and concerns around family planning. This is especially important for LGBTQ+ families as the cost associated with having a family can often be much higher for queer couples. It is critical for Illinois voters to understand what the assisted reproductive question is and how it connects to the expansion of family planning services for LGBTQ+ couples.

Decoding Project 2025: Fight Back Against this Anti-LGBTQ+ Agenda:  Project 2025’s goal is for extreme conservative ideals to be enacted across multiple Federal agencies, to inform state legislation, and to train appointees in its conservative tenets through an online “education academy.” Project 2025 is comprised of numerous harmful policy proposals that would harm access to healthcare, economic security, and social services support, especially for already vulnerable and marginalized communities.  Project 2025 specifically targets LGBTQ+ people and lays out a clear plan to erode or eliminate non-discrimination protections for LGBTQ+ people.

Decoding Project 2025: A Danger to Healthcare Access: Project 2025 is a comprehensive plan to enact extreme conservative policies that would reduce access to healthcare, economic security, and social services support. Project 2025’s goal is for conservative ideals to be enacted across every level of federal and state government. One of the primary goals of Project 2025 is to reduce access to necessary healthcare services specifically for LGBTQ+ people and other marginalized communities.

Safe Spaces: Combating Housing Disparities for LGBTQ+ Individuals: Homelessness and unstable housing in Chicago is one of the largest issues among LGBTQ+ and people living with HIV (PLWH). Social and economic barriers, including anti-LGBTQ+ housing discrimination, have long been a barrier to the safety and welfare of queer and trans people. There is a need for increased funding for affordable housing and cultural competency training for shelters, landlords, and housing providers to help eliminate the housing crisis among LGBTQ+ people.

Funding The Future of Healthcare: Community Health Centers (CHCs) are vital providers of healthcare in the United States, providing care to around 31 million people annually. CHCs provide affordable, high-quality, comprehensive primary care to medically underserved populations regardless of insurance status or ability to pay. Most CHC patients are people of color, and the vast majority are low-income. Learn more about CHC funding issues and how you can help support the critical work of CHCs

Beyond The Ballot: Vote For Chicago’s First Elected School Board: This November, Chicago will hold elections for the Chicago Board of Education (CBE) for the first time. Based on a law passed in 2021, the Chicago Board of Education will transition from a seven-member board appointed by the mayor to a 21-member elected board. This will eventually make the CBE the largest school board in any major city. The CBE oversees Chicago Public Schools (CPS), a large public school system that educates an average of 325,000 students annually. Learn more about this important and historical decision for voters this November.

Beyond the Ballot: Fueling Acceptance for LGBTQ+ Students in Our Schools: School boards are responsible for a wide range of academic, legal, and financial issues impacting our students’ quality of education. For example, boards often approve curricula, evaluate student achievement, and oversee the hiring of superintendents; all of the day-to-day things that impact our children’s lives. As such, their decisions have far-reaching consequences for students, families, and communities. Understand how school boards function and be as informed as possible on who should be on your community’s school boards when it comes time to vote.

Important Things to Keep in Mind

Get Ready to Vote: Rights to Accommodations: To help ensure that everyone is able to access voting in this upcoming election, below are some special circumstances and ways to prepare yourself or someone you know to vote in November.

Understand the State and Local Positions on your Ballot: With the variety of local, county, and state positions on our Midterm ballots, it is essential to understand and be informed about how these elected officials may impact your life!

Judges are on the Ballot: When it comes to advancing equitable and affordable healthcare for all, the idea of judges and court systems does not always immediately come to mind. However, the judicial system can have a profound impact on civil rights and access to healthcare, especially for marginalized populations like the LGBTQ+ community. Especially with the current surge of anti-LGBTQ+ political attacks, it is more important than ever to make your voice heard

To learn more about how Howard Brown Health contributes to vital advocacy work and has an impact on local, state, and federal policymaking, please visit our Advocacy webpage.

Following two years of service to the community beginning in 1974, Howard Brown Health was officially incorporated as a non-profit organization in the State of Illinois. In that document, our founders laid out our core purpose: 

“To provide health care and related services
without regard to affectional or sexual preference” 

We’ve come a very long way in the decades since then, maturing from a tiny office above a market to a network of healthcare centers across Chicago. From the very beginning, our community members have turned to Howard Brown for compassionate, high-quality care when urgent health needs arise.  

In good times and in bad, Howard Brown’s doors have always been open, ready to serve the unmet needs of our patients with our focused approach to medicine. As the needs of our community have grown and changed, so have we. We’ve grown to support our community by ensuring an inclusive, comforting healthcare experience for all. Howard Brown is turning 50, but our story is only just beginning. 

After decades in the fight for our lives, we know what it’s like for the people we love to be lost too soon, and we don’t take growing old for granted. The concept of growing old was revolutionary when we helped develop the first hepatitis B vaccine. And during the AIDS epidemic, many of the youngest and most vibrant among us were not given the chance to reach old age. 

Today, we continue to fight for the legacy of those we’ve lost, redefining what it means to live extensive, healthy lives, free to be ourselves and free from fear. We recognize that even today it is revolutionary to grow and age healthfully, especially for those most marginalized.  Together, we stand by our commitment to grow older together – with our community, with our providers, and with our patients. 

Whether your friends are your family, you’re newly married, or you’re putting kids through college, we all want to grow old alongside the people we love most. As we celebrate 50 years of liberated healthcare that empowers patients and ignites social justice from a place of wellness and health equity, Howard Brown keeps getting better with age — and you can, too. Let’s Grow Old Together. 

As we begin our 50th Anniversary, we have a lot planned to celebrate our past, present, and future alongside our patients, staff, and broader community. This year, we will do just that by sharing our histories, highlighting community stories, and forging a path forward into the next 50 years of Howard Brown Health. We can’t wait for you to join us. 

On your ballot this November, there will be a non-binding advisory question regarding insurance coverage for medically assisted reproductive treatments. While this question is not binding, it will serve as a way for Illinois legislators to better understand your needs and concerns around family planning. This is especially important for LGBTQ+ families as the cost associated with having a family can often be much higher for queer couples. It is critical for Illinois voters to understand what the assisted reproductive question is and how it connects to the expansion of family planning services for LGBTQ+ couples.

An advisory question is a type of ballot measure that asks voters a non-binding question. The largest difference between an advisory vote and any other type of ballot measure is that the outcome of the ballot question is not legally binding and will not directly result in a new, changed, or rejected law or constitutional amendment. Rather, the advisory question allows voters to express their general opinion on important issues. The Assisted Reproductive Healthcare Advisory Question is asking voters to, “advise state officials on whether to provide for medically assisted reproductive treatments, including in vitro fertilization, to be covered by any health insurance plan in Illinois that provides full coverage to pregnancy benefits.” While Illinois does have some family planning insurance coverage protections for LGBTQ+ couples, this question is essentially asking if individual Illinois health plans should be required to fully cover all assisted reproductive treatments without any copays or limits. A “yes” vote would support advising state officials to provide for medically assisted reproductive treatments while a “no” vote opposes advising state officials to provide for medically assisted reproductive treatments.

Illinois has several pieces of legislation that already support LGBTQ+ couples and their family planning needs. HB 3709 expanded the definition of fertility to include a person’s inability to reproduce either as a single individual or with a partner without medical intervention. Previously, infertility was defined as a failure to establish a pregnancy or to carry a pregnancy to live birth after several months of regular, unprotected sexual intercourse. This automatically excluded same-sex couples and single individuals from insurance coverage for infertility treatments. For example, a woman from Illinois sued Blue Cross Blue Shield after learning her fertility treatments with her same-sex partner weren’t going to be covered because their IVF definitions only offered full coverage for IVF after couples failed to conceive after 12 months. This meant that many same-sex couples couldn’t receive insurance coverage or had reduced coverage for participating in many of the same procedures heterosexual and cisgender couples were accessing. In addition to HB 3709, Illinois also has the Reproductive Health Act (RHA) a law (Public Act 101-0013) Pritzker signed in 2019 and added to in 2023 (Public Act 102-1117) that helps protect access to in-vitro fertilization (IVF). Much of this legislation was enacted because accessing family planning like IVF for LGBTQ+ couples was difficult and costly.

The Assisted Reproductive Healthcare Advisory Question could be an important next step in letting legislators know there are still needs around access to IVF and other family planning services for LGBTQ+ families. This is becoming more important as attempts in Congress to codify the right to IVF access have failed. The cost of IVF is in the tens of thousands of dollars. A single IVF cycle – a period of about three weeks in which eggs are collected from an ovary, fertilized by sperm in a lab, and then transferred to a uterus – can cost upwards of $20,000, including medication. LGBTQ+ individuals statistically have higher rates of poverty and financial instability, so the high out-of-pocket costs can leave many queer families unable to access these services. These costs can increase even more as LGBTQ+ couples may have the added expenses of needing sperm donors, egg donors, surrogates, or gestational carriers. This advisory question is one way that voters can urge legislators to take another look at how the current IVF protections in Illinois can be more inclusive and less cost prohibitive. This may include requiring unlimited coverage for all IVF treatments or providing financial support for surrogacy. Let’s ensure we are supporting LGBTQ+ families across Illinois!

Election Day is November 5! You can register to vote here. You can also check your registration or apply for an absentee ballot. You can also visit the Illinois Board of Elections for more information.

To learn more about how Howard Brown Health contributes to vital advocacy work and has an impact on local, state, and federal policymaking, please visit our Advocacy webpage.

Nearly 2.9 million Illinoisians are now 60 or older, representing 22% of the population in Illinois. Far too many older adults experience abuse, neglect, poor care, isolation, and difficulty finding affirming and supportive spaces. For LGBTQ+ older adults, the barriers and discrimination they face when trying to access healthcare and social support are compounded due to anti-LGBTQ+ discrimination and lack of knowledge of LGBTQ+ health. As the population in Illinois continues to age, there needs to be a comprehensive plan to support the aging population. That is why we worked with Illinois Aging Together to advocate for the needs of LGBTQ+ older adults, leading to the Governor recently authorizing an executive order to establish a planning commission to develop and implement a multi-year Multi-Sector Plan for Aging (MPA). The MPA will serve as a 10-year blueprint to support healthy aging in Illinois and set clear, measurable objectives for evaluating public and private sector progress toward this goal. Learn more about how this plan will advance the health, mental, and social needs of LGBTQ+ older adults!

The Multi-Sector Plan for Aging (MPA)

LGBTQ+ older adults face unique challenges. Healthcare access, supportive and stable housing, and community support systems can look different for LGBTQ+ older adults compared to other older adults for a variety of reasons. For example, LGBTQ+ older adults are twice as likely to be single and live alone and four times less likely to have children. LGBTQ+ older adults are also far more likely than heterosexual peers to have faced discrimination, social stigma, and the effects of prejudice. This discrimination has far-reaching effects on health outcomes and financial stability: LGBTQ+ older adults are more likely to face poverty and homelessness, and more likely to have poor physical and mental health. One-third of LGBTQ+ older adults live at or below 200% of the federal poverty level, while LGBTQ+ older adults are more likely than non-LGBTQ+ to be told they have cancer at 29% and 23% respectively. Without intentional interventions focused on meeting the specific needs of LGBTQ+ older adults, LGBTQ+ older adults will continue to experience stark disparities in physical and mental health outcomes including higher rates of cardiovascular disease, frailty and mobility issues, depression, and substance and alcohol misuse.

Illinois Aging Together, a coalition of 188 organizations including Howard Brown Health, has been drafting and advocating for legislation for years that would create a commission to develop a multi-sector plan for aging. The Governor’s executive order creating the MPA was a huge advocacy achievement for Illinois Aging Together. The MPA will serve as another component to support older adults in every facet of their lives and serve as a blueprint to enact much-needed state legislation around aging. Stakeholders around the state will help draft the MPA in conjunction with an MPA planning commission, The Department of Aging, and other stakeholders.  A final MPA will be delivered to the Governor and General Assembly by 2025, and an additional status report by 2026. The MPA is a comprehensive plan and has several focuses including:

• Removing barriers to accessing healthcare: The plan aims to increase access and reduce the cost of primary care, behavioral, neurological, oral, and audiological healthcare, and prescriptions, across the state. It plans to institute geriatric and dementia education requirements for all healthcare providers. It will ensure that an older person’s right to self-determination is respected and upheld. Removing barriers to healthcare is incredibly important for LGBTQ+ older adults as well as older adults living with HIV. In Illinois, 47% of PLWH were 50+. As this population ages, we know that other health issues become a major concern. HIV may affect the biology of aging and as a result, older adults with HIV may suffer from aging-related illnesses such as dementia, arthritis, and certain cancers earlier and at higher rates than those without HIV. If we don’t eliminate LGBTQ+ older adults’ barriers to healthcare, social services, and other supports, the long-term physical, mental, and overall costs of treatment could lead to worsening health outcomes or even death.
• Strengthen and improve service infrastructure for the quality, staffing, accessibility, and availability of long-term services and supports: Illinois nursing homes had the lowest staffing in the nation across the five years reviewed by USA TODAY. In 2022, 91% of nursing homes did not meet state and federal staffing guidelines. It is already difficult for LGBTQ+ older adults to access long-term services as they are more likely to face discrimination when seeking services, have lower incomes, and need more social services than some of their cisgender or straight counterparts. With a focus on infrastructure, staffing, and accessibility, this goal of the MPA will better enable older LGBTQ+ persons to remain in their homes and communities according to their wishes (to age-in-place), or to utilize nursing homes safely.

The Multi-Sector Plan for Aging is one way we can acknowledge and support the unique needs and experiences of LGBTQ+ older adults. This can be a guiding light for service providers, advocates, and aging networks as they look to pass legislation or understand how these issues impact the lives of LGBTQ+ older adults. You can learn more about this important Executive Order and the MPA by visiting here and here. You can visit Howard Brown’s website for more information on our policy priorities and state legislative agenda. You can also visit our Advocacy page to learn more about our work.

Each summer, Howard Brown Health welcomes a group of undergraduate students to our organization for The Gregory Shapen Public Health Fellowship. The Shapen Fellowship focuses on developing project management skills in the field of public health and community medicine. This summer, we were delighted to have six fellows join us, working with our Education, Advocacy, Diabetes Care, and Behavioral Health teams. Each student devised and developed their own project over the course of our ten week fellowship, working in partnership with a Howard Brown Health Mentor. We are proud to share summaries of their work with us this summer.

Ifeyinwa Allanah, she/her/hers (Education and Behavioral Health)

Research Proposal: Effects of Menstrual Cycles and Hormonal Contraceptives on the Mental Health Quality of Life (MHQoL) of Cisgender Women (18-40 yr/o)

The menstrual cycle is an important aspect of reproductive health, influencing various physiological and psychological processes. Attention has increasingly turned towards understanding how these cycles, along with the use of hormonal contraceptives, impact the mental health quality of life (MHQoL) of individuals, particularly cisgender women aged 18-40. This observational study aims to explore the relationship between menstrual cycles, the use of different types of hormonal contraceptives, and MHQoL. By focusing on women who are either using combination hormonal contraceptives, progesterone-only contraceptives, or no hormonal contraceptives at all, this study seeks to uncover potential differences in the MHQoL across these groups, which could lead to more personalized and effective healthcare strategies for cis women experiencing menstrual-related mental health challenges.

Grace Courter, she/her/hers (Education)

Toolkit: Sapphics on Sex

Despite advances in LGBTQ+ health, significant gaps remain in research and services for sapphic individuals. This student-led project aims to create a comprehensive sapphic sexual health toolkit to address common misconceptions and provide accurate information about sexual health for sapphic people. The toolkit will empower individuals to make informed decisions and offer advocacy strategies for spreading awareness. Our goal is to reduce health disparities in the LGBTQ+ community, enhance sapphic sexual health knowledge, and promote inclusive sex education. We seek to ensure all sapphic individuals have access to accurate and comprehensive sexual health resources.

Sophia Hwang, she/her/hers (Diabetes Care)

NDPP Implementation Plan: Diabetes Prevention Program Implementation and Best Practices: Howard Brown Health

National Diabetes Prevention Program (NDPP), which we hope to offer at Howard Brown. In addition to researching how to successfully implement the NDPP, I investigated stress as a risk factor for chronic disease among LGBTQ+ populations, as well as potential strategies to address patients’ social needs that may be barriers to participation. This process involved reviewing literature, consulting other NDPP providers, and surveying patients, which provided valuable insight on how to tailor the NDPP to the specific needs of Howard Brown’s patient population.

Pietro Juvara, he/him/his (Policy and Advocacy)

Legal Guide: The Legal History of 340B

As part of the Advocacy team at Howard Brown this summer, I developed a guide to the legal history of the federal 340B Drug Pricing Program. 340B requires drug manufacturers to sell their products at a discounted rate to organizations like Howard Brown, which then get reimbursed by private insurance companies at market price, creating “340B savings” to help provide accessible healthcare. Since 2020, manufacturers have been slowly dismantling 340B in major lawsuits. Through studying landmark cases, I developed a guide to the legal defense of 340B for any health center to use, with findings on its current legal vulnerabilities, and recommendations for health organizations to apply in their own advocacy work and protect their 340B savings.

Naima McRoberts, she/her (Education and Behavioral Health)

Research Paper: Integrating Behavioral Healthcare into Primary Care for LGBTQ+ Adolescents with Chronic Pain 

This summer, I conducted an independent research project reviewing the literature on primary care behavioral health integration and LGBTQ+ adolescent chronic pain disparities to argue for the benefits of integrating behavioral health care into primary care.  My mentor, Dr. Kelly Ducheny was a leader in establishing integrated care at Howard Brown, so I was grateful to have her as a resource as I worked on this project.  I also spent time shadowing therapist Dondee Gujilde and got to see integrated care in action.  With my project, I hope to highlight the intersections of health disparities in minority communities and the urgent need for holistic and accessible health care.

Ari Zweibaum, she/they (Education)

Gender Affirming Care Guide: Guide to Transition Options in the Midwestern United States

Transgender and Gender Diverse (TGD) people often seek ways to change their existence in society to feel more comfortable in their own skin through a process called transition. However, this process can be very abstract and confusing to TGD people who are early on in their journey. The Guide to Transition Options in the Midwestern United States seeks to help remove information barriers by making it easier for TGD people to visualize their transition and work towards a life they want to lead. It explains in detail what goes into various forms of social, medical, and legal transitions to create a more welcoming environment for TGD people.

To learn more about the vital work done by the Education Department at Howard Brown Health, please visit our Education webpage.

At Howard Brown Health, we are proud to announce an upcoming tribute that will honor the legacy of the Lesbian Community Cancer Project (LCCP). In late Spring 2025, we will unveil a tribute wall on the third floor of our Halsted Clinic (3501 N Halsted), celebrating the incredible impact of LCCP and its contributions to our community.

Founded in 1990 by a group of passionate individuals, LCCP emerged as a vital resource for women with cancer and their families of choice. At a time when healthcare settings often lacked inclusive care, LCCP created a space for lesbians to find support, solidarity, and care. From direct services to peer groups, LCCP’s work not only provided care, but also created a community that lifted one another through grief, loss, and the triumphs of beating cancer. In 2007, LCCP merged with Howard Brown to expand the agency’s ability to serve LGBTQ+ women and their families.

The tribute wall will be a lasting memorial located in the waiting area of our Halsted Clinic. This will be a space for reflection and recognition of the individuals and families who shaped LCCP and contributed to its lasting impact on healthcare equity and community-building.

Tracy Baim, a Chicago-based LGBTQ+ journalist, editor, author, and filmmaker is leading the project. “LCCP was so important to us finding community together,” shares Baim. “When it started at the Women’s Gym, LCCP was a space to support one another through grief and loss and celebrate when we beat cancer. It’s important that we remember and name the people who helped build that supportive community.”

In addition to memorializing those connected to LCCP, the tribute wall will be a reminder of the broader contributions lesbians have made to the health and well-being of the LGBTQ+ community. All donations up to $50,000 will be matched by an anonymous donor and all gifts will support access to care at Howard Brown.

“Honoring LCCP at Howard Brown Health Halsted gives us an opportunity to look back on some of the lesbians who helped our community age alongside one another,” said Katie Metos, Vice President of External Relations, “Lesbians have always been a backbone to the Queer community.”

We invite our community to participate in this tribute. For gifts of $500 or more, your name and the name of your honoree will be included on the donor wall. If your loved one wasn’t directly connected to LCCP, we offer other ways to honor them. All gifts, regardless of size, will ensure that you and your honoree are recognized in our annual report and on a dedicated webpage celebrating LCCP.

This tribute wall is a meaningful opportunity to reflect on the work that has been done, honor those who were part of it, and ensure that the spirit of LCCP continues to inspire future generations. We encourage everyone to be part of this lasting memorial.

For more information on how to contribute and participate, please visit donate.howardbrown.org/lccp.

Together, let’s honor this incredible legacy and ensure it continues to inspire our community members for many years to come.

by Center for Education, Research, and Advocacy

Project 2025 is a comprehensive plan to enact extreme conservative policies that would reduce access to healthcare, economic security, and social services support. Project 2025’s goal is for conservative ideals to be enacted across every level of federal and state government. One of the primary goals of Project 2025 is to reduce access to necessary healthcare services specifically for LGBTQ+ people and other marginalized communities. We must take action now to stop the elimination of vital healthcare services and non-discrimination protections in healthcare!

Medicaid and Medicare Access

Project 2025 recommends that the Department of Health and Human Services (HHS) evaluate some of its programs for cuts or alterations to services. For example, Project 2025 calls to restructure the 340B Drug Pricing program. The Federal 340B drug discount program has required pharmaceutical manufacturers to sell drugs at a discount to covered entities, including safety net hospitals and FQHCs that care for uninsured and low-income patients. This allows FQHCs to pass along the discounts directly to uninsured patients to help them afford their medications. When we dispense medications to insured patients, we can generate 340B in savings or revenue—at no cost to the patient—that FQHCs use to provide and expand essential services and programs. For example, Howard Brown uses our 340B savings to help fund our HIV and PrEP navigation programs, our trans and non-binary health teams, our Broadway Youth Center, and other crucial services for our patients that are often poorly reimbursed and underfunded. Project 2025 would restructure this program restricting the amount of revenue FQHCs could generate. This would result in fewer affordable medications for underinsured or uninsured patients and a critical funding loss for community health centers.

Project 2025 also calls for stark reductions in funding to state Medicaid programs. Currently, the federal government guarantees to match payments made by the states for services provided to Medicaid patients with no pre-set limits. In states with lower per capita incomes, the federal government pays a larger share of Medicaid funding. Project 2025 proposes a “balanced or blended match rate,” which would provide a flat funding rate to all states. This would eliminate a substantial amount of federal funding for state Medicaid programs, ultimately resulting in reductions in the medical workforce and services for low-income Americans. Project 2025 also calls for more stringent and burdensome eligibility requirements for Medicaid coverage, including work requirements. Work requirements for Medicaid coverage have been shown to be ineffective in helping Medicaid recipients attain employment, and instead just result in many low-income patients losing their Medicaid coverage. For example, when Arkansas briefly implemented work requirements in Medicaid, 1 in 4 participants lost their health coverage. Project 2025 also recommends applying lifetime coverage caps for Medicaid. This would mean that once a person has been on Medicaid for a set amount of time, they can no longer access Medicaid benefits. People who have been on Medicaid for a certain number of months or years could immediately lose eligibility for Medicaid coverage. Project 2025’s eligibility requirements would result in around 18.5 million people at risk of losing their coverage.

Medication Affordability

Project 2025 also proposes the repeal of the Inflation Reduction Act (IRA). The IRA greatly helped reduce the out-of-pocket drug costs for more than 1.5 million Medicare Part D enrollees. Importantly, it capped out-of-pocket costs at $2,000. Medicaid Part D recipients are some of the most vulnerable patients with significant health needs, and repealing the IRA would see Part D enrollees lose upwards of $7.4 billion in out-of-pocket savings next year. This would be especially harmful to people living with HIV (PLWH). When it comes to the costs of HIV treatment including doctor visits, labs, mental health access, and ART medication, about 60% of these costs come from the high cost of medications alone. The costs of HIV medications are estimated to run between $500-$4500 each month during a person’s lifetime.  Increasing the costs of HIV treatment or having HIV treatments be mostly, if not fully out-of-pocket, will lead to less PLWH being able to afford their life-saving medications.

Abortion and Reproductive Healthcare

Since the Dobbs v. Jackson Women’s Health Organization decision eliminated the constitutional right to an abortion, Project 2025 now aims to enact policies that would amount to a nationwide abortion ban. These attempts to erode or eliminate access to abortion access will lead to providers denying care due to fear of being prosecuted and ultimately result in increased health disparities and poorer health outcomes. States that currently have abortion restrictions report fewer reproductive health providers. There is a 32% lower ratio of obstetricians to births and a 59% lower ratio of certified nurse midwives to births. States with abortion restrictions experience 62% higher maternal death rates than states with full abortion access. States with abortion bans also see higher rates of mental health conditions, including suicide and substance use disorder overdoses, as the most frequently reported causes of preventable pregnancy-related deaths. According to the Center for American Progress, if a nationwide abortion ban is enacted, the overall number of maternal deaths would rise by 24%. Maternal deaths for Black women would rise by 39%. Abortion access is also an important healthcare issue for LGBTQ+ people. A survey by the Guttmacher indicates that LGBTQ+ people make up as many as 16% of U.S. abortion patients.

Project 2025 also focuses on eliminating access to abortion pills via the mail. Project 2025 would try to weaponize the long-dormant Comstock Act to try and make the delivery of medication abortion by mail illegal. Without a mailing option for medication abortion, the steep logistical and financial burdens of travel will put abortion care out of reach for many patients. Project 2025 also calls to eliminate access to free no-cost emergency contraception that millions of people rely on. This could result in over 47 million reproductive-age women losing access to no-cost contraception.

LGBTQ+ Non-discrimination Protections

Project 2025 aims to eliminate non-discrimination protections for LGBTQ+ patients by reverting Section 1557 of the ACA to the 2020 version enacted under the Trump Administration. This would mean eliminating the general prohibition on discrimination based on gender identity and sex stereotyping and adopting blanket religious freedom exemptions for health care providers making it easier for LGBTQ+ patients to be denied care based on a provider’s religious beliefs. The Trump Section 1557 rule also removed sexual orientation and gender identity nondiscrimination protections in several Centers for Medicare & Medicaid Services (CMS) programs. This was especially heinous as many of the impacted CMS programs disproportionately benefit LGBTQ+ individuals.

LGBTQ+ people have long experienced discrimination and barriers when seeking healthcare. Based on a 2022 survey by the Center for American Progress (CAP), 15% of LGBQ respondents—and 23% of LGBQ people of color—experienced care refusal by a provider in the past year. For trans and non-binary (TNB) individuals, 32% reported that they experienced care refusal by a healthcare provider in the past year. Rates of discrimination were even higher for TNB people of color, with 46% reporting care refusal. The CAP survey also showed that 55% of intersex respondents reported a healthcare provider refused to see them because of their sex characteristics or intersex variation. For TNB patients, having their insurance cover necessary and affirming medical care has become an ever-increasing obstacle. In the past year, 30% of TNB patients, including 47% of TNB patients of color, reported at least one form of denial by a health insurance company, including denials for necessary gender-affirming hormone therapy or gender-affirming surgery. Delaying or avoiding healthcare due to discrimination contributes to poorer health outcomes for LGBTQ+ individuals, including higher rates of chronic diseases like heart disease, certain cancers, asthma, and strokes. Discrimination also takes a toll on mental health, with LGBTQ+ patients having higher rates of mental health distress and suicidality. With the increasing number of anti-LGBTQ+ legislation, including gender-affirming care bans, the elimination of anti-discrimination polices for LGBTQ+ patients will result in increased poor health disparities.

Conclusion

Project 2025 will infiltrate many levels of healthcare access and patients’ ability to afford their treatments. Creating barriers to accessing Medicaid, enacting harsh abortion restrictions, and eliminating non-discrimination protections would be detrimental to the health of all Americans.

It is vital we understand these threats. You can read more info about what Project 2025 is and how extensive Project 2025 goals are. You can also read our blog on the state of anti-LGBTQ+ legislation.

With the Presidential election coming up in November, it is important to vote for candidates that support the civil rights and equity of everyone. Be sure you are registered to vote. To register to vote, receive information on voting by mail, find a polling location, or get updates on the upcoming election you can visit your local election boards for more information.

• For residents of Chicago, you can get more information at www.chicagoelections.gov
• For residents of all of Cook County, including Suburban Cook County, you can go to www.cookcountyclerkil.gov/elections
• For all residents, regardless of where in Illinois you reside, you can go the Illinois State Board of Elections at www.elections.il.gov.

To learn more about how Howard Brown Health contributes to vital advocacy work and has an impact on local, state, and federal policymaking, please visit our Advocacy webpage.

by Center for Education, Research, and Advocacy

This election year there has been much discussion around Project 2025, a political transition plan being pushed by a coalition of conservative extremists. Project 2025 is comprised of numerous harmful policy proposals that would harm access to healthcare, economic security, and social services support, especially for already vulnerable and marginalized communities. Project 2025’s goal is for extreme conservative ideals to be enacted across multiple Federal agencies, to inform state legislation, and to train appointees in its conservative tenets through an online “education academy.” Project 2025 specifically targets LGBTQ+ people and lays out a clear plan to erode or eliminate non-discrimination protections for LGBTQ+ people. It is imperative to understand what Project 2025 is so that we can take action to prevent this threat from taking hold!

What is Project 2025?

Project 2025 is a 900-page document published by the Heritage Foundation that is meant to serve as a road map for a conservative extremist federal government. Project 2025 contains a 180-day playbook of regulations and executive orders that could be signed and implemented by the next conservative president upon taking office. It also includes a database of potential presidential appointees and information on the kinds of bills conservatives in Congress and state legislatures should attempt to enact. Project 2025 contains plans for enacting long-standing extreme conservative idealsthat impact all aspects of everyday life, including reducing federal spending on social services for low-income people, eliminating efforts to fight climate change, increasing military spending, and impeding reproductive and sexual healthcare access, to name a few.

Project 2025 was created by the Heritage Foundation. Founded in 1973, the Heritage Foundation is a conservative think tank whose mission is “to formulate and promote public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values, and a strong national defense.” As part of furthering their mission, the Heritage Foundation has a long history of anti-LGBTQ+ advocacy. For example, the Heritage Foundation has fought against out LGBTQ+ military service, LGBTQ+ Boy Scouts and leaders, marriage equality, protections against discrimination for LGBTQ+ workers, rights of LGBTQ+ parents, bans on conversion therapy,  evidence-based healthcare for trans youth, and LGBTQ+ inclusive curricula. The Heritage Foundation took a leading role in the conservative movement in the 1980s during the presidency of Ronald Reagan, whose policies were informed by the Heritage Foundation’s Mandate for Leadership. The Mandate for Leadership would continue to be released every Presidential election year as a way for the Heritage Foundation to instill conservative and traditional ideals into the federal government. Project 2025 is the name for this year’s iteration of the Mandate for Leadership.

The main difference between Project 2025 and past Mandate for Leadership editions is the massive coalition of conservative and far-right groups that have contributed to Project 2025, uniting under this singular vision. Some high-profile organizations that have contributed to Project 2025 alongside the Heritage Foundation include the Family Research Council (FRC), Alliance Defending Freedom (ADF), and the American Legislative Exchange Council (ALEC). All these organizations have a long history of being powerful lobbyists on behalf of conservative causes. Many of these organizations are designated hate groups by the Southern Poverty Law Center due to their goals and activities being based on a shared antipathy towards people based on race, religion, ethnicity/nationalities/national origin, gender and/or sexual identity.  The goal of many of these groups is to reduce or eliminate LGBTQ+ rights using legislative advocacy. Project 2025 is a consolidation of these groups’ decades-long campaigns to erode or eliminate many non-discrimination protections for the LGBTQ+ community.

How does Project 2025 affect the LGBTQ+ community?

Given the anti-LGBTQ+ work of many of the groups behind Project 2025, it is not surprising that one of Project 2025’s main goals is to drastically roll back rights for the LGBTQ+ community to promote “life and strengthening the family.” Many of these policy changes would be enacted by the President through executive orders and presidential appointments. Just a few of these actions would include:

• Department of Justice (DOJ): Project 2025 would encourage the DOJ to pursue litigation that is consistent with the agenda of the President. This means litigators with the DOJ would be encouraged to prosecute someone performing abortion care or providing gender-affirming care (GAC) to someone traveling from another state where that care is banned, or where the language on how and when these procedures can be given is vague. This would cause providers of services like abortion and GAC to refuse to provide these services out of fear of prosecution. This would put the physical and mental health of LGBTQ+ patients at risk.
• Department of Health and Human Services (HHS): Project 2025 recommends that the future HHS secretary reverse focus on LGBTQ+ equity, and instead enact policies that encourage “marriage, work, motherhood, fatherhood, and nuclear families.”  Project 2025 urges for policies that protect adoption and foster agencies that refuse to work with LGBTQ+ couples, as well as bans on in-vitro fertilization (IVF)—preventing many LGBTQ+ people from becoming parents. Project 2025 also would eliminate free birth control access and enact a national abortion ban.
• Medicaid: Project 2025 calls for imposing targeted time limits or lifetime caps on Medicaid benefits. Similar policies have previously been introduced, including a proposal to impose a 36-month lifetime maximum for Medicaid coverage. It also proposes introducing a work requirement to be eligible for Medicaid coverage, even though work requirements for Medicaid have been shown to reduce insurance coverage for patients while not increasing employment. These proposals would greatly limit and restrict access to Medicaid, and this would disproportionately impact LGBTQ+ communities. LGBTQ+ people utilize Medicaid at higher rates than non-LGBTQ+ with around 21% of LGBTQ+ adults in the U.S. accessing Medicaid every year. This would put millions of LGBTQ+ patients at risk of losing their healthcare coverage immediately as Project 2025 may retroactively impose these limits.
• Supreme Court: Project 2025 calls for not only limiting the application of the Supreme Court’s ruling in Bostock v. Clayton County,which held that Title VII’s sex discrimination protections applied to LGBTQ+ Americans, but also threatens to prevent the ruling from extending to other sexual and gender minority communities, such as two-spirit, intersex, an asexual Americans.
• Department of Defense: Project 2025 threatens to reverse policies allowing trans individuals to serve in the military.
• Department of Education (DOE): Project 2025 calls for eliminating the DOE. This would eliminate most of the mechanisms to enforce non-discrimination protections for LGBTQ+ students and put their lives and well-being at risk.

How can we fight back against Project 2025?

Project 2025 is just the beginning of a long-term plan to eliminate protections for LGBTQ+ and other marginalized people. First, it’s important that you learn more about what Project 2025 is. You can read more info about what Project 2025 is and how extensive Project 2025 goals are. You can also read our blog on the state of anti-LGBTQ+ legislation.

With the Presidential election coming up in November, it is important to vote for candidates that support the civil rights and equity of everyone. Be sure you are registered to vote. To register to vote, receive information on voting by mail, find a polling location, or get updates on the upcoming election you can visit your local election boards for more information.

• For residents of Chicago, you can get more information at www.chicagoelections.gov
  • For residents of all of Cook County, including Suburban Cook County, you can go to www.cookcountyclerkil.gov/elections
  • For all residents, regardless of where in Illinois you reside, you can go the Illinois State Board of Elections at www.elections.il.gov.

To learn more about how Howard Brown Health contributes to vital advocacy work and has an impact on local, state, and federal policymaking, please visit our Advocacy webpage. 

Every year, Howard Brown Health (HBH) supports several state legislative priorities to advance healthcare for LGBTQ+ patients. There were some important LGBTQ+ health equity and healthcare funding bills that Howard Brown and our community advocated for and passed during the 2024 Illinois General Assembly Legislative Session!

State Budget

The FY 2025 State budget and recently passed Medicaid omnibus bill includes a few vital funding provisions that will help health centers in Illinois. Legislators included an increase of funding for the HBIA/HBIS or Healthy Illinois for All programs for ages 42 and older in the state’s FY25 budget. This will provide $440 million from the General Revenue Funds and $189 million from other sources for a total of $629 million. This will help further close coverage gasps as it provides Medicaid-like coverage for low-income residents regardless of immigration status. This funding is necessary with the influx of immigration into Chicago from Central and Latin America. This additional funding will positively impact Howard Brown’s patients to gain better access to healthcare coverage. On average 30% of Howard Brown patients utilize Medicaid, and 21% are uninsured or qualify for a sliding scale.

An additional $40 million above the initial proposed appropriation was given to implement the HOME Illinois plan to prevent and end homelessness. This funding will primarily be focused on rental assistance, homeless prevention, and funding to address youth homelessness. 28% of LGBTQ youth report experiencing homelessness or housing instability at some point in their lives. Howard Brown’s Broadway Youth Center provides support for LGBTQ+ youth experiencing homelessness or unstable housing and this funding will go a long way in helping LGBTQ+ youth find the safe and stable housing they deserve.

There are some important additions to the 2025 Medicaid omnibus bill around psychiatric care and medication access. SB3668 will lift unnecessary prior authorization (PA) requirements for certain psychiatric medications so patients can get vital medications as soon as they need them. This budget will also increase Medicaid psychiatry reimbursement rates (SB3668) and increase rates for psychiatric evaluations and substance use disorder treatment, as well as medication monitoring performed by community mental health centers (HB4664). The cost of psychiatric care can be high for patients and Medicaid reimbursement rates in Illinois are historically low compared to neighboring states. Increasing these reimbursement rates will make psychiatric care more affordable for low-income residents. This will allow places like Howard Brown where a large population of our patients use Medicaid for their healthcare coverage to affordably treat more patients.

Diversity, Equity, and Inclusion

In this session, we were able to see the passage of the Nonprofit Board Diversity Reporting Bill (SB2930). Illinois will now require non-profits that provide $1,000,000 or more in grants each year to release aggregated demographic information of its board of directors and officers. This includes race, ethnicity, gender, disability status, veteran status, sexual orientation, and gender identity. This is to ensure non-profit boards and leadership are reflective of the populations they serve. We want to applaud our partners at Equality Illinois for their leadership in the passage of this bill!

The other bill, the Support Trans Candidates Running for Chicago’s Elected School Board Act (HB4924) would update the Illinois School Code to ensure trans individuals who are candidates for Chicago’s elected school board don’t have to publish their deadnames on their nominating petitions. This requirement is harmful to trans and gender-diverse individuals who would be forced to release a deadname or inadvertently out themselves as these names would become public record. While these bills did not pass this session, we will continue to advocate for these important bills.

340B

Even with the wins this legislative session, there is still further advocacy work to be done. One major bill that unfortunately didn’t pass this session was the Illinois Patient Access to 340B Pharmacy Protection Act (SB3727). This bill would prohibit pharmaceutical manufacturers from prohibiting, restricting, or interfering with a local pharmacy that contracts with a 340B covered entity, including community health centers like Howard Brown, to dispense medications acquired through the 340B program. This legislation will help to ensure that the medications needed by patients are available at their local pharmacies and safeguard critical 340B savings that we invest in expanding services and programs our patients rely on. We can still do lots of advocacy to ensure the 340B program is protected. Congress recently introduced the 340B ACCESS Act (HR 8574) aimed to ensure 340B’s long-term viability as a critical resource for Community Health Centers and their patients. You can show your support for the 340B Access Act by contacting your Representatives and telling them we need Congress to take action and reform the 340B Program to ensure we can continue to serve our nation’s most vulnerable patients.

Insurance Coverage and Prior Authorization

We strongly advocated for The Prior Authorization Reform Act (HB5051) which would prohibit health insurance providers from requiring prior authorization for a prescription drug prescribed to a patient by a healthcare professional for 6 or more consecutive months. Many of our patients have experienced denials of coverage for necessary and life-saving medications due to burdensome and unnecessary prior authorization requirements from insurers. This bill would also prohibit prior authorization requirements for certain specific FDA-approved prescription drugs, including insulin, human immunodeficiency virus prevention medication such as PrEP and PEP; human immunodeficiency virus treatment medication; viral hepatitis medication; and hormonal therapy drugs used for gender-affirming care. We are continuing to push for this legislation as it will provide immediate and life-saving medications for our patients.

The Illinois legislature passed a SB3203 that would cap patient costs for prescription inhalers at $25 a month. The bill’s passage follows years of outcry from patients with asthma and other lung conditions over the cost of inhalers. The annual per person medical cost for asthma prescriptions was $1,830. The passage of this bill will relieve the high financial burden of rising inhaler costs.

The passage of the Healthcare Protection Act (HB5395) will ban PAs for admission for inpatient psychiatric services for the first 72 hours on an inpatient stay. These will help make access to psychiatric medications and inpatient care more available. When needed it also bans step therapy, an insurance practice that requires a patient to try a lower-cost drug or therapy first. This will ensure that patients have access to the medications that best suits their needs.

Education and Training

There were a couple of bills focused on education introduced in this session that HBH strongly supported. The Supporting Implementation of the Keeping Youth Safe and Healthy Act (SB3384) requested an appropriation of $20 million in the FY25 State Budget as a grantmaking program to support those public school districts that want to teach comprehensive sex education that is vital to the health and safety of Illinois students. This would have helped eliminate barriers to teaching comprehensive sex education by funding much needed training and curriculum development.

We also sought to pass the LGBTQ+ and HIV Cultural Competency for Legal Professionals (HR582) that urged the Illinois Supreme Court to adopt a continuing education mandate for LGBTQ+ and HIV cultural competency education for attorneys, judges, and courtroom staff. LGBTQ+ and people living with HIV (PLWH are disproportionately incarcerated and have negative experiences when trying to access legal services due to their identities and HIV status. While the cultural competency for legal professionals resolution was adopted by the house, it failed to advance. We are committed to fully pushing this bill through in the upcoming legislative sessions.

HIV Treatment and Prevention

There are a couple of HIV-related budget appropriations HBH advocated for that would ease the burden of individuals getting tested for HIV and connected to healthcare quickly. However, for the first time in the last four fiscal years, state legislators did not include any new HIV-related funding in the state’s Fiscal Year 2025 budget. There are several HIV-related budget items that will operate with level funding for the FY 2025 budget.

• Getting to Zero (GTZ) Illinois Omnibus budget which is a state-wide initiative to end the HIV epidemic in the state by 2030 ($5.5 million). 
• HIV treatment and prevention services, also known as the HIV Lump Sum ($25.5 million). 
• The African American HIV/AIDS Response Act (AAHARA) funds grants to Black-led community-based organizations and HIV services meant to address the disproportionate impact of HIV/AIDS on African Americans and other communities of color ($15 million). 
• Grants and administrative expenses for the distribution of PrEP medication access ($2 million). 
• The Quality-of-Life Endowment Fund for grants related to HIV/AIDS prevention and education ($1 million). 
• Administrative expenses associated with STI testing, treatment, and prevention. ($500,000). 

We would like to thank our partners at AIDS Foundation of Chicago for all their hard work and leadership on securing this important funding.

The Strengthening & Protecting Illinois HIV Funding Infrastructure (SPIHFI): (HB5667) bill would have provided an $2 million increase in state funding for HIV education, prevention, testing, and treatment. This would include $2.5 million in new funding to launch eight Rapid Start for HIV Treatment pilot sites that establish HIV treatment standards that would connect people with treatment within 7 days of initial diagnosis or 7 days of referral to HIV medical care. While this bill didn’t pass, we will fight to increase access to HIV testing and treatment in Illinois. We would like to thank our partners at AIDS Foundation of Chicago for all their hard work and leadership on this bill.

the Connection to HIV Testing and Linkage to Care (LTC) Act (HB5417) would enact reforms to ease HIV-testing and connection to treatment by mandating at-home HIV and/or sexually transmitted infections (STIs) testing kits be covered by insurers and Medicaid without cost-sharing; create 8 rapid start pilot sites that would connect people with treatment within 7 days of initial diagnosis or within 7 days of referral to HIV medical care; and ensures that all county jails provide HIV/AIDS education to people who are incarcerated and visitors, as well as link them to HIV testing as mandated by Illinois’ County Jail Act. It is vital that people newly diagnosed with HIV gain access to treatment and other wrap-around services as soon as possible. HB5417 passed the Illinois House with a bipartisan, unanimous vote, but the bill was unable to advance through both chambers. We will continue to fight for people to gain immediate access to the healthcare they need. We would like to thank our partners at AIDS Foundation of Chicago for all their hard work and leadership on this bill.

To learn more about how Howard Brown Health contributes to vital advocacy work and has an impact on local, state, and federal policymaking, please visit our Advocacy webpage.