New research from the Center for American Progress shows that the Affordable Care Act, or ACA, is making significant headway in connecting lesbian, gay, bisexual and transgender, or LGBT, individuals and their families with affordable, high-quality health insurance coverage, but more remains to be done.
In 2013, one in three LGBT people eligible for financial assistance to gain coverage under the Affordable Care Act were uninsured. By 2014, that number had dropped to one in four, or 26 percent. In short, over the single year that encompassed the first open enrollment period under the ACA, the rate of uninsurance among low- and middle-income LGBT adults fell 8 percentage points, or 24 percent.
“The substantial drop in uninsurance among LGBT individuals eligible for financial help to access coverage underscores the importance of the health reform law for promoting both the health and economic security of LGBT people and their families,” said Kellan Baker, the lead author of the report and a Senior Fellow at the Center for American Progress. “LGBT health is an LGBT equality issue—especially for LGBT groups that are particularly likely to live in poverty, such as women, people of color, and transgender people.”
The report’s findings show significant drops in uninsurance across the board for different LGBT groups, as well as positive experiences among those who explored their options through Medicaid and the marketplaces, enrolled in coverage, and attempted to access health care using their new coverage.
However, the report notes that 26.8 percent of gay men, 20.5 percent of lesbians, 26.7 percent of bisexual people, and 34.7 percent of transgender people with incomes less than 400 percent of the federal poverty level did not have insurance in 2014. Uninsurance remains a particular concern for LGBT respondents of color: 33.1 percent of respondents who identified as black and 32.5 percent of respondents who identified as Hispanic were uninsured.
The report highlights several areas in which targeted efforts are still needed to help reach LGBT community members with accurate information about the law; encourage them to enroll in coverage; and ensure that coverage is affordable, adequate, and equitable. These areas include:
- Enforcing LGBT nondiscrimination in access to insurance coverage
- Ensuring quality and comprehensiveness of coverage, especially for transgender people
- Requiring LGBT inclusion in consumer outreach and education activities
- Providing LGBT cultural competency training for navigators and other enrollment assisters
- Collecting voluntary LGBT data in enrollment
- Strengthening the link between coverage and culturally appropriate care for LGBT people
To help address these challenges, the Center for American Progress is a founding steering committee member of Out2Enroll, a nationwide initiative launched in 2013 that seeks to connect LGBT people and their families with their new health insurance coverage options under the ACA.
“The Affordable Care Act has already begun to transform how our health system works, and as we continue to design a system that serves some of the most marginalized among us, we are helping reach everyone who needs quality health coverage, including LGBT Americans,” said Laura E. Durso, Director of the LGBT Research and Communications Project.
The Center for American Progress is a nonpartisan research and educational institute dedicated to promoting a strong, just and free America that ensures opportunity for all. We believe that Americans are bound together by a common commitment to these values and we aspire to ensure that our national policies reflect these values. We work to find progressive and pragmatic solutions to significant domestic and international problems and develop policy proposals that foster a government that is "of the people, by the people, and for the people."
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