Last month, the Fifth Circuit Court of Appeals ruled in favor of the Trump administration and Republicans in Texas vs. United States, striking down as unconstitutional the ACA’s individual mandate and remanding to the lower court judge a final decision on what parts of the ACA should be eliminated – the very judge who has already ruled the entire law unconstitutional. 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 Fifth Circuit’s disastrous decision on President Trump’s Texas lawsuit puts the health care of millions of Americans at risk. The court’s decision will impact every corner of the American health care system, threatening key protections for the LGBTQ community and access to care for children, seniors, women and individuals with disabilities in communities across the country,” said Protect Our Care Executive Director Brad Woodhouse. “Over these days of action, we will be reminding Americans what’s really at stake if the courts ultimately overturn the health care law.” 

Days of Action: Day 5 of 11 focuses on LGBTQ Health Care. 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. 

If the ACA is overturned, key protections for LGBTQ 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.