We have reached a critical point for the future of American health care and the fate of the Affordable Care Act (ACA). On June 25th, Trump’s Department of Justice (DOJ) and Republican-led states submitted their briefs in support of California v. Texas, the lawsuit seeking to strike down the ACA. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. The consequences of the lawsuit for America’s health care are particularly devastating at a time the country is gripped by the coronavirus crisis which threatens the health and safety of the entire nation.

No action would be more damaging to Americans’ health and safety than if the Trump administration achieves their desired goal of overturning the ACA in its entirety during this crisis. When the court hears this case, there will likely be no vaccine and no viable treatment for the virus. When millions of Americans have already lost health insurance due to the pandemic, it’s absurd that President Trump is arguing in court that 20 million more Americans should lose their health care. And when millions of Americans who contract the coronavirus join the 135 million Americans with a pre-existing condition, President Trump will also be arguing in court to allow insurance companies to deny them coverage or charge them more. The submission of these briefs from Republican states will put the Trump administration’s politically-motivated lawsuit on full display for the American people in front of the highest court.

Days of Action: Day 7 of 12 focuses on protections for LGBTQ Americans. To learn more about our Days of Action, visit our website.

What’s At Stake: LGBTQ Health Care

The LGBTQ community has unique health care needs and has often experienced high rates of uninsurance and barriers to coverage and care, such as discrimination on the basis of gender identity and sexual orientation. A study by the Center for American Progress found that 15 percent of LGBTQ Americans were uninsured in 2017, compared to only seven percent of non-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 2017, it was 22 percent. The ACA ensures that insurance companies cannot deny coverage, drop coverage for no reason, or charge LGBTQ people more because of a pre-existing condition. The ACA’s Medicaid expansion also plays a key role in ensuring LGBTQ adults are covered.

LGBTQ people are especially at risk during the coronavirus pandemic. They are more likely to suffer from chronic conditions that put them at higher risk for developing serious complications if they contract the coronavirus, and research shows LGBTQ Americans are extremely vulnerable to the economic impact of the pandemic. It’s critical that Americans understand just what’s at stake if this lawsuit succeeds as the nation is still reeling from the pandemic. 

If the ACA is overturned, key protections for LGBT Americans would be ripped away overnight: 

LGBTQ Americans, women, and individuals with disabilities could face discrimination in health care settings. Section 1557 of the ACA prohibits discrimination 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 adults covered under Medicaid expansion would lose coverage. The ACA expanded Medicaid to childless adults and increased income eligibility levels nationwide, helping many LGBTQ Americans gain coverage. Among all LGBTQ respondents in a 2017 Center for American Progress study, 18 percent had Medicaid coverage. By comparison, Medicaid covered eight percent of non-LGBTQ respondents. An estimated 1.8 million LGBTQ adults have Medicaid coverage. 

Protections for pre-existing conditions would be eliminated. Because of the ACA, insurance companies cannot deny coverage to individuals 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.