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ACA At 11: Health Care For LGBTQ Americans

By March 23, 2021No Comments

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land, and millions of people gained coverage and critical protections as a result. The LGBTQ community has unique health care needs and has historically experienced high rates of uninsurance and barriers to coverage and care, such as discrimination on the basis of gender identity and sexual orientation. The ACA’s consumer protections, along with the expansion of Medicaid and creation of financial assistance to help people purchase marketplace coverage, made affordable health care a reality for many LGBTQ Americans. 

After four long years of Republican efforts to repeal and sabotage the ACA, President Biden and Democrats in Congress are now working to build on the strong foundation of the law to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. Making coverage more affordable and accessible is especially important for LGBTQ people, who are significantly more likely than non-LGBTQ people to live in poverty and to face barriers to accessing care. The health care measures in the American Rescue Plan will have profound impacts on disparities in health care access and outcomes, particularly as the COVID-19 pandemic has hit LGTBQ Americans much harder than others. 

Thanks To The ACA:

The ACA Prohibits Discrimination Of LGBTQ Americans, Women, And Individuals With Disabilities In Health Care Settings. Section 1557 of the ACA prohibits discrimination on the basis of race, color, national origin, sex, age, or disability by any health program or activity receiving federal assistance. It also prohibits these types of discrimination in health programs and activities administered by HHS as well as the ACA marketplaces. 

LGBTQ Americans Cannot Be Denied Coverage Or Charged More For Pre-Existing Conditions. Because of the ACA, insurance companies can no longer deny coverage to individuals or charge them more because of pre-existing conditions. This includes transgender-related medical history as well as substance use disorders, HIV, depression, and other conditions disproportiately affecting LGBTQ Americans. According to the Center for American Progress, 65 percent of LGBTQ adults had a pre-existing condition in 2017, compared to 51 percent of all U.S. adults. 

A Closer Look At How The ACA Is Working For LGBTQ Americans:

The ACA Dramatically Reduced Uninsured Rates For LGBTQ Americans. Before the ACA came into effect, one in three (34 percent) LGBTQ people making less than $45,000 per year were uninsured. Just one year after the health care law was implemented, in 2014, the rate of uninsurance for this group dropped to 26 percent and by June 2020, it was 16 percent. The Center for American Progress estimates that nearly 900,000 LGBTQ adults are covered through the ACA marketplaces. 

Medicaid Expansion Played A Key Role In Expanding Coverage To LGBTQ Americans. The ACA expanded Medicaid to childless adults and increased income eligibility levels nationwide, helping many LGBTQ Americans gain coverage. A June 2020 survey from the Center for American Progress found that in states that adopted Medicaid expansion, just 8 percent of LGBTQ adults were uninsured. By comparison, in states that have rejected expansion, the rate of uninsured LGBTQ adults was 20 percent. CAP estimates that nearly 2 million LGTBQ people are covered by Medicaid nationwide.