Photo Credit: CityOfStPete via Flickr: Creative Commons License
Community Catalyst, Out2Enroll and health advocacy organizations across the country are marking National LGBT Health Awareness Week to bring needed attention to LGBTQ health disparities and to reaffirm our strong commitment to promoting LGBTQ health equity. Our celebration of LGBT Health Awareness week is extra sweet this year: Republican efforts to repeal the Affordable Care Act (ACA) and dismantle Medicaid – actions that would have had a devastating impact on the LGBTQ community – were thwarted last week after the House of Representatives decided not to proceed with a vote on the American Health Care Act. This news is a huge victory for LGBTQ individuals and their families, many of whom were at risk of losing access to high-quality, affordable health care coverage and critical consumer protections offered under the ACA.
While we savor our successes this week, we know more efforts to undermine the ACA are right around the corner. That’s why this year’s LGBT Health Awareness Week theme, ACT OUT for LGBT Health! Action on Health Access & Equity, is more important and relevant than ever. It is imperative that we speak out and take action to spotlight the incredible gains we have made in eroding LGBTQ health disparities thanks to the ACA. The ACA has helped many LGBTQ individuals access health insurance, get covered as a family, receive financial help to make coverage more affordable, and access covered health services, including transition-related care, for the first time.
LGBTQ Communities Continue to Benefit from the ACA
Last week, the Center for American Progress (CAP) released new research that explores in depth how the ACA continues to benefit LGBTQ communities. The coverage gains we have made under the ACA for LGBTQ individuals are nothing short of impressive: as CAP’s research highlights, “In 2013, before the ACA’s coverage reforms came into effect, one in three LGBT people making less than $45,000 per year (34 percent) were uninsured. Just one year later, in 2014, uninsurance for this group had dropped by one-quarter to one in four (26 percent), and by 2017, CAP’s study finds that it was around one in five (22 percent).” In short, the uninsured rate among low and middle-income LGBTQ individuals has dropped by 35 percent since the ACA became law.
Not only has the ACA significantly increased the number of LGBTQ individuals and their families with health insurance coverage, but the law also provides more affordable coverage options through subsidies on the health insurance Marketplace and through expansion of Medicaid. Access to affordable health care coverage is particularly critical for LGBTQ people. Because of a long history of oppression and discrimination, CAP’s report points out that LGBTQ people, particularly LGBTQ people of color and transgender people are more likely to live in poverty and earn less than non-LGBTQ people. CAP’s research shows that access to financial assistance on the Marketplace or through Medicaid helps LGBTQ individuals and their families feel more confident that they can afford regular and major medical costs. The ACA also requires health insurance plans to cover certain essential health benefits important to the LGBTQ community that ensure coverage of critical services such as HIV testing and mental health screenings.
The ACA (and its protections) remain intact, for now.
While the ACA remains intact and LGBTQ people are still protected from discrimination in health care and health insurance, we must stay vigilant as health care debates continue in Congress, the White House and at the U.S. Department of Health and Human Services (HHS). Harmful changes to the ACA not only come in legislative form like the failed American Health Care Act but significant changes can also emerge through executive action and regulatory reform. For example, just last week HHS eliminated questions about LGBTQ older adults and LGBTQ people with disabilities from two surveys, the National Survey of Older Americans Act Participants and the Annual Program Performance Report for Centers for Independent Living. This data provides HHS with critical information on the effectiveness of its programs and helps HHS identify persisting health disparities among people in the LGBTQ community. The Trump Administration also rejected a proposal to collect data on LGBTQ people in the 2020 census. We must continue to speak out and act when harmful policies like these are proposed by decision makers in Washington.
We celebrate this year’s LGBT Health Awareness Week with great pride and accomplishment. Over the last four months, millions of people across the country came together to tout the benefits of the ACA and oppose any measures that would cut coverage or result in higher costs for consumers. We made our voices heard by gathering at rallies and Town Hall events, calling and writing to our legislators and getting active on social media. The failure of the American Health Care Act and our victory last week should remind us that when we #ActOut for our health care, we can make an enormous difference. This week, the LGBTQ community and our supporters need to continue to #ActOut4LGBTHealth and show that the ACA is working for LGBTQ people and their families.
The guest blogger for this piece is Katie Keith; Katie is a member of Out2Enroll's Steering Committee