One medical myth facing Americans is that by the age of 65, when most of us are eligible, Medicare will relieve the cost pressure of their health insurance plans.
In fact, premium costs, deductibles, and out-of-pocket expenses are just as much a problem for Medicare recipients as they are for the general population. For LGBTQ elders, who often face greater health care and financial issues. choosing the wrong Medicare plan can be a disaster.
That’s where Trusty.Care comes in. Founded two years ago by Joseph Schneier, a trans man married to a trans woman, the digital health company provides health insurance brokers with the platform to help consumers pick the plan that minimizes out-of-pocket costs.
“Most of us approach retirement thinking Medicare will cover us and it will be okay, but it’s a major risk area,” says Schneier. “We decided to build a platform used by insurance brokers and others to assess the risk to older adults of incurring out of pocket costs and match them up with the right product for the most coverage at the least risk based on the individual’s preference.”
That simple idea turned to be a winner–literally.
Last month, AARP Innovation Labs and End Well Foundation selected Trusty.care as the winning startup in a national competition in which startups pitched ideas to help transform the experiences of aging, illness, and caregiving in America. (You can watch Trusty.Care’s winning pitch here.)
“AARP Innovation Labs supports and sponsors pitch competitions in a continued effort to make meaningful impacts on the challenges of aging,” says said Jacqueline Baker, Director of Innovation Programming, AARP Innovation Labs. “The needs of LGBTQ older adults are too often overlooked in the marketplace, and it never surprises us when people who have overcome their own life challenges, in turn, help others to overcome challenges as well, which is what Joseph and the other finalists are doing.”
Schneier was well-positioned to tackle the Medicare out-of-pocket problem. For more than a decade, he has worked in the health care space, so he was able to identify a problem in search of a solution.
“People are surprised to see that health care costs are the second largest expense for seniors and the least able to be controlled,” says Schneier. Indeed, health care costs are a leading cause of a sharp rise in bankruptcy among American seniors. Bankruptcy is “growing fastest among older adults, and almost always because of health care costs,” notes Schneier.
Trying to match the right plan with seniors’ needs has always been a challenge. But the need for a solution has only grown since Trusty.Care launched, thanks to a change in government policy.
“Up until last summer, most people used the government Medicare.gov finder,” Schneier says. “But then Medicare.gov removed the ability to save medication information.” Because medication costs are a key driver of out-of-pocket expenses, the change made it difficult for insurance brokers to project just how much a plan would end up costing each consumer.
As a result, says Schneier, “There is a tremendous hunger for products like ours in the market.” That change also exposed that the market hadn’t kept pace with change. “It was definitely operating like it was 1995 and didn’t mind too much. The change forced their hand.”
The pandemic has also accelerated change, as more seniors follow shelter-in-place policies to protect their health.
“Since you can’t meet face to face, people are looking for digital solutions,” notes Schneier.
At present, Trusty.Care has a staff of eleven. “We have a very diverse team,” says Schneier. “People know from the get-go that this is a space the is by definition inclusive. People are attracted to us who wouldn’t necessarily have a place at the table.”
Schneier says that being trans has informed who he is as a leader.
“Being trans, and especially being trans masculine–I’ve taken that as an opportunity for me to emulate what a man can be in leadership,” he says.
Schneier also sees the inherent privileges that come from being a white male.
“There are definitely a lot of times when it’s a confusing space to be a passing trans person passing as a white male,” he says “I have a lot of layers of privilege that are not obvious to everyone. I’m married to a trans woman, and her life is significantly more complex.”
As just one example of the privilege that comes with being male, Schneier notes that raising money for his company now is a lot easier than it was as a woman.
The assumptions people make sometimes force Schneier to challenge them.
“There are definitely moments where I’m in situations where people will assume I’m a straight, white, cis man and say things that really put you in the position of needing to speak up,” he says.
In the meantime, Trusty.Care is growing by leaps and bounds.
When it launched, the platform had just 10 brokers. By the end of this year, the company expects to have 20,000 brokers using the platform. Since each broker can bring in thousands of customers, the company will be serving the needs of a significant number of seniors, a growth trajectory that many tech firms would envy.
Throughout this progress, Schneier is keeping his sights on what drove him to found Trusty.Care in the first place.
“Our mission is that no retiree should go through bankruptcy because of out-of-pocket costs,” he says. ” We can’t change everything, but we can change what we can.”
For more information on how AARP is helping LGBTQ seniors, visit AARP.org/pride or WATCH the recent AARP Pride Town Hall Below:
This week’s Extra! Extra! covers a few topics that haven’t gotten much attention in our coverage lately: big tech and the surveillance state, a look at America’s broken education system from several angles and violence against women. We continue to provide an update on the Black Lives Matter protests, immigration and the COVID-19 pandemic.
Natalie: Remember when progressives were calling for the elimination of the Department of Homeland Security and conservatives (both Democratic and Republican) absolutely lost their shit? What better indication that the Department of Homeland Security is a pointless entity than the revelation that it has time to devote to protecting statutes? I am astounded that the government thinks that this is a worthy use of American taxpayer dollars.
The most important question, though, is: what’s the constitutional basis for this? While the memo purports to prohibit “monitoring activities protected by the First Amendment or the lawful exercise of other Constitutional or legal rights, or for the purpose of suppressing or burdening criticism or dissent, it’s hard to read this as something other than an effort to do precisely that.
Himani: For the various reasons described in this article, this is generally a good thing from a police accountability standpoint. But the question I am always, always left with is: How are tech companies using this data for their own self-serving and nefarious purposes?
Natalie: To your point, Himani, I’m reminded again of Andrew Yang’s campaign plank about treating data as property and I’m becoming increasingly convinced that it’s the only way to protect ourselves against the misuse of our data by tech companies.
With respect to the article, though, I think this is a really underreported aspect of the pandemic… not just interrogations — but I do think it’s interesting how this takes away officers’ ability to intimidate — but with the conduct of the judicial system as a whole. If we had a working justice department, perhaps there’d be more energy invested in creating a pathway for all aspects of the judicial system to continue working in the wake of this pandemic. Right now, we’re just accepting the suspension of people’s 6th Amendment rights and, honestly, the presumption of innocence, as if it doesn’t matter.
Rachel: I very much agree with Himani’s concerns about the long arm of tech’s involvement here, and hope that on the whole the takeaway that we settle on for this development is not “we need more tech disruption in justice” but “we actually get more and better justice when we abandon the myth of the cop as central and heroic.” The specific things that are being ID’d here as helpful — safer, more open conversations with suspects with community being able to observe the interaction — aren’t just arguments against intentionally threatening and violent police practices, although they are, but are arguments against the cop (even “good” cops like detectives) as primary driver and authority in investigations of crimes overall. The practices described here — intimidating, confusing and threatening witnesses, creating psychologically coercive environments, crafting narratives of guilt and blame that citizens are then challenged to disprove — aren’t just a few occasional police techniques, they’re part of what police are. What’s left when you remove them from interrogation is just “asking someone what happened and documenting their responses,” and evidence here shows that we actually get better results when we do that — and we don’t need a militarized police force for that.
Himani: This was an incredibly disturbing read and is more consistent with my usual understanding of tech’s role in law enforcement and the criminal justice system: more tools for civilian surveillance that no one has any reasonable way of opting out of.
Himani: Related to the above point about surveillance technology, the situation in Hong Kong puts into relief what has been true around the world for a while now: Tech companies hold a substantial amount of political power. Their decisions make and break movements, which is literally the case in Hong Kong right now. Apple invested in the Chinese market, and, to that end, it is willing to cave to the Chinese government’s censorship demands in Hong Kong at this critical moment in Hong Kong’s history.
Rachel: This is all so heartbreaking and enraging, and I’m thinking of all these stories in tandem with the absurd statue defense army developments above. Specifically: none of this is necessary. None of this needed to happen, and none of this is about making anyone safer or protecting anyone that matters. It is an exercise of power for the sake of power, harm and destruction for the sake of destruction.
Are We Hurtling Towards an Authoritarian State? Or Are We Already in One?
Himani: This situation in Portland and Trump’s subsequent dispersal of federal forces to cities across the US is just … honestly I have no words. As Slate reports, “The Federal Protective Service has the authority to make arrests ‘if the officer or agent has reasonable grounds to believe that the person to be arrested has committed or is committing a felony.’” The bar for arresting someone seems to be going lower and lower by the minute. Which is a disturbing prospect, given everything we know about what happens, particularly to Black people, in police “custody” and in correctional institutes. In the words of the late John Lewis, “One of my greatest fears is that one day we wake up and our democracy is gone.”
And just as predictably as the Republicans’ knee-jerk response, came the response of Democrats: folding like a cheap suit amid the criticism (despite the fact that they’d issued a similar report on Leftwing Extremism earlier in the year). Napolitano apologized and the report was shelved.
We’ve known for a long time how these groups operate and what their motivations are…and even though this administration feels obliged to divert attention to the lesser threat, the facts still remain.
Natalie: I think this headline is a tad misleading: voting restrictions are ineffective only if you believe that they are a legitimate effort to prevent voter fraud… which, of course, is the reason Republicans give when they’re passing legislation like Voter ID. If you accept that voting restrictions are not actually meant to prevent voter fraud — because, as numerous studies have shown, it hasn’t — but instead to disenfranchise a specific segment of voters, then voting restrictions are highly effective. Voting restrictions are created to reduce the size of the electorate and bolster Republican chances in the general election…whatever it costs, monetarily or in terms of diminishing our democracy, it’s worth it to Republicans.
Everything That Is Broken in the American Education System
Natalie: I’ll admit: I’m surprised it took this long for Republicans to use the pandemic as an opportunity to undermine public education. I thought, for sure, that there’d be a big push for a divestment from public schools during the pandemic and a reallocation to pre-existing online schools like Connections Academy that already have the infrastructure in place to support online education. Then, once schools moved to reopen, there’d be a shortfall and kids would move to charter/private schools out of necessity. But no matter what path they took: the idea that Republicans — especially Besty DeVos, given her history of grifting money from Michigan to fund unaccountable charter schools — would seize on this as an opportunity to erode our public education system.
Himani: Unlike Natalie, I really didn’t see this coming because I was so caught up in the healthcare and economic side of what was going on with the pandemic. There are so many things I can say about “school choice” and all of its failings, but I will focus on just two. First, the Orlando Sentinel reported earlier this year that many schools receiving state money have explicit anti-LGBTQ+ policies. Second, school choice has had a direct role in increasing inequality. As Michael Seeling explains writing for SSIR: “School choice doesn’t necessarily drive schools to compete for best practices; it more often drives them to compete for the best kids, the students who are easiest—and cheapest—to teach.”
Himani: Natalie perfectly captured everything that needed to be said about this in our conversation in Slack: “Small government conservatism being proven for the farce that it is!”
And for further context on this point:
Would that be the same Senator Tom Cotton (R-Arkansas) who in 2017 said, “I’m glad to see Congress push back against this federal overreach. Now states and local communities can decide how best to educate their children.”
Also, because I am bad with names, it wasn’t until I did some digging into this latest news that I discovered that this is the same Tom Cotton who wrote that infamous op-ed for the New York Times invoking the US military to respond to the Black Lives Matter protests in June.
Rachel: As a ~media professional~, I have to admit that my first thought in reaction to this story was what a resounding testimonial it is to the success of the 1619 Project — although Cotton’s vile move here isn’t something to celebrate, it’s hard to imagine a clearer sign that your work on clarifying the real facts of America’s history is doing its job than hardline Republicans doing everything in their power to suppress it.
Natalie: Both these pieces were really helpful for me. As I mentioned a few weeks ago, in reading the Supreme Court’s decision in McGirt v. Oklahoma, it was hard to get my mind around the selective enforcement of treaties and respective for Native sovereignty…and both these pieces helped crystallize my thinking on those issues a bit more.
Rachel: I echo Natalie, and want to point up the question in the Intercept article — what if all Native treaties were upheld? — and its significance. Clearly America right now is going through something of a mainstream (white) reckoning of just how much of the fabric of its identity and present as a nation was formed by chattel slavery — a lot! arguably all of it! — and similarly, the questions of what treaties were made with the Indigenous people of North America from when it was colonized into the 19th century and the ways in which they were broken have had a determining role in almost everything about our nation as it is today. Looking at that closely has to be part of any conversation around what justice looks like and how it can be embodied.
Natalie: So the Department of Homeland Security has time to watch statues but it doesn’t have time to run a basic records check to see if its employees have histories of child abuse? The agency is behaving similarly with subcontractors who, according to a recent report by the Associated Press, are keeping migrant children as young as 1 year old, IN HOTELS to skirt the asylum process and allow for immediate deportation. DHS and ICE claim those subcontractors have been trained but won’t say “whether they’re licensed child care professionals or have received FBI background checks”
Rachel: So even just within the realm of domestic immigration policy, we can see a multiplicity of the ways that the Trump administration has undermined even the limited advances made by previous leaders — with DACA, they tried to shutter the program and ended up going through the court system, but with some programs like asylum, they (in an extreme oversimplification) just… quietly stopped doing it. As we are being reminded in so many ways right now, there’s what the law says and what those in power actually do, and sometimes even when they’re in conflict, nothing happens. Even though Trump’s admin lost on DACA—- a huge victory that I don’t want to dismiss or undercut! — there’s a remaining question of whether they’ll actually, like, do it. This court order is an attempt to make them do so, instead of starving the DACA program through inaction where they failed to effectively execute it; will it work? We’ll see!
Rachel: My feelings on all of these stories together are a sort of Greek chorus of “I told you so”s of varying emotional registers. We know that repeatedly demonstrated misogyny is a prime indicator for violence! We have seen this so, so many times! Why do we keep having to read stories like this and think “oh, look, it happened again”? We know that when women don’t have access to resources to safely leave their homes or be financially solvent outside of a marriage or nuclear family, they are at incredible risk for violence, and they die. Why do we have to watch that happen over and over and over again on a policy level? We know that there are myriad ways forward that don’t rely on a carceral state, and that if you just listen to criminalized folks like sex workers or women trying to escape violence (arguably a criminalized demographic especially when those people are women of color and Black women), you can see them modeled in real life! I think there is maybe some kind of crystallized larger lesson to take from these stories together that I am a little too worn out from reading these over and over to articulate – maybe it’s just that yet again, these are the places the state (globally) is repeatedly failing us; these are the places where the most successful solutions are being modeled by communities that care about each other.
Natalie: We don’t think enough about what these folks are witnessing…sure, they see death regularly but not like this…not so many people, in a relatively short amount of time, at the hands of the same malady. It’s awful. These will be the uncounted casualties of COVID-19…those workers who have to stare an unprecedented amount of death in the face and either learn to live with it or take their own lives, like Dr. Lorna Breen or John Mondello.