The Affordable Care Act: Providing for LGBTQ People
The Affordable Care Act (ACA), also known as Obamacare, has proven to be a positive resource for many Americans who are not insured. Healthcare disparities have captured the attention of many in the United States, but research has rarely studied the disparities in health insurance coverage between the LGBTQ and non-LGBTQ population. 29% of LGBTQ adults do not have health insurance, in comparison with 21% of the general adult population. The gap is even higher when looking at particular subgroups. With adult women, for example, 29% of lesbian, bisexual, transgender, and queer women stated not having insurance compared to only 16 % of non-LBTQ women. Fortunately, the ACA has given many LGBTQ populations who have traditionally lacked health insurance the opportunity to sign up for healthcare at little or no cost.
For many years, LGBTQ people have experienced discrimination in the healthcare system because of who they are. In one recent study on transgender people, 19% of respondents reported that someone refused them medical care because of their gender identity and 28% had postponed medical care because of discrimination. Section 1557 of the ACA prohibits discrimination on the basis of gender identity as well as sex, sex stereotypes, race, color, national origin, age, and disability. That means that being transgender is no longer a “pre-existing condition” that can be used to deny health coverage, but it also means that no one who is LGBTQ should face discrimination when trying to obtain health insurance or healthcare.
The ACA also requires the funding of a more diverse and culturally competent workforce within the healthcare system. This will help reduce discrimination within healthcare centers and also provide a more approachable space for many LGBTQ people in need of healthcare services. It is important for LGBTQ people to take advantage of this protection under the ACA and get the healthcare that they need.
Research shows that discrimination, such as being fired from a job or the stress from staying in the closet out of fear of rejection, correlate with physical and mental health disparities between LGBTQ and non-LGBTQ people. This is especially true for LGBTQ youth, who are up to 3 times more likely to attempt suicide. The ACA allows these young people to be able to get the mental health care that they need in order to prevent any kind of self-harm. We are also aware that up to 40% of youth experiencing homelessness are LGBTQ: their ability to have affordable or free health insurance will be one less thing for them to worry about. Some LGBTQ subgroups also disproportionately suffer from chronic illnesses like asthma and diabetes. With proper, affordable health insurance, these chronic illnesses can be better managed and will help reduce the healthcare disparity that exists between LGBTQ and non-LGBTQ people.
More LGBTQ people have become insured since the ACA went into effect: that number went up by 4.4% for LGBTQ people compared to 3.5% for non-LGBTQ people. A study on LGBTQ people and the health insurance market showed that although 65% had heard about the ACA’s health insurance coverage requirement, only 32% of people knew about the new affordable plan options. Even after learning about the tax credits and subsidies that will help make coverage affordable, 63% did not believe they would be able to find a plan they could afford.
There are many resources available to help LGBTQ people find coverage they can afford. The guide, Where to Start, What to Ask: A Guide for LGBT People Choosing Health Care Plans and the website Out2Enroll explain the many benefits the ACA offers LGBTQ people, and answer many frequently asked questions. It is important for LGBTQ people to consider applying for healthcare through the Affordable Care Act: we have a long way to go before reaching full health equity for LGBTQ people, but signing up for healthcare during the ACA’s open enrollment is an important stepping stone. The deadline to enroll for 2016 coverage is January 31.
by Alan Lopez, National LGBTQ Task Force, Communications Intern