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It's MORNING EDITION from NPR News. I'm Steve Inskeep. Gay civil rights groups have sought changes in health care policy for years without success. Now they have a chance. That's because of several provisions in the health care bill that the House of Representatives passed over the weekend. NPR's Joseph Shapiro reports.

JOSEPH SHAPIRO: One provision would end a tax penalty for same-sex couples. Allison Herwitt, of the Human Rights campaign, explains why her group has long pushed for the change.

Ms. ALLISON HERWITT (Human Rights Campaign): Today, when employers offer health coverage to an employee's domestic partner, the value of that coverage is treated as taxable income to the employee.

SHAPIRO: For a heterosexual couple there's no tax if a husband puts his wife on the insurance he gets through his company, or if a wife puts her husband on her insurance. But tax policy doesn't treat same-sex couples that way, since they can't legally marry. Herwitt says the tax penalty can be significant, typically up to $1,700 a year when the working partner is making $33,000 a year.

Ms. HERWITT: So many same-sex couples, particularly those of low and moderate incomes, can't afford this tax burden and they decline the health coverage for the partner.

SHAPIRO: Another provision in the House bill would let states use Medicaid money to cover poor people with HIV, instead of waiting until they develop full-blown AIDS.

Ms. JENNIFER KATES (Kaiser Family Foundation): It's called a catch-22.

SHAPIRO: That's Jennifer Kates of the Kaiser Family Foundation, an independent health care foundation. Right now, to qualify for Medicaid you have to be poor or disabled.

Ms. KATES: Now, for people with HIV, this has presented a real challenge since the advent of antiretrovirals. You know, you have drugs that can prevent you from becoming really sick and disabled, yet you can't get onto the very program that you need to access these drugs, because they're expensive.

SHAPIRO: There's another provision in the bill that would let government gather data looks at disparities in health care based on sexual orientation and gender identity. And there's language to prevent denial of health care.

Opposition didn't come up during the House debate. One reason may be that some of the groups opposed in the past were focused on other fights, including one to restrict funding for abortion. But none of the provisions are in the Senate bills, so supporters are getting ready to protect them when and if the Senate and the House have to reconcile their different versions.

Joseph Shapiro, NPR News.

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