In commemoration of LGBT Health Awareness Week, the Center for American Progress and the National Coalition for LGBT Health have released a new report examining how the Affordable Care Act affects the LGBT community and how they and their allies can “continue to advocate for broad inclusion as the law is fully implemented between now and 2014.” Authors Kellan Baker and Jeff Krehely offer four specific recommendations for how the federal government and the states can ensure that the law is implemented with the community in mind:
- Achieving comprehensive nondiscrimination protections in health insurance exchanges: HHS should issue “explicit antidiscrimination protections regarding gender identity and sexual orientation in all aspects of insurance.”
- Establishing LGBT-inclusive data collection policies: Section 4302 also allows the secretary of HHS to designate additional groups that experience health disparities and would benefit from improved data collection. The Secretary should include sexual orientation and gender identity.
- Recognizing and including LGBT families in all health reform activities: HHS should issue rules ensuring that, to the extent permitted by law, the full diversity of families in the United States, including LGBT-headed families, are eligible for new benefits and programs.
- Supporting community-based health interventions that are LGBT-inclusive: the definition of “community” must be expanded beyond physical boundaries toward an understanding of communities shaped by shared identities and common health disparities.
The report notes that America’s health care crisis is only magnified in the LGBT community, which suffers from discriminatory laws that limit access to dependent health care coverage and — given burden of minority stress — “also faces elevated risk for substance use and mental health conditions such as depression, anxiety, eating disorders, and suicidal ideation.” For instance, “gay, lesbian, and bisexual adults are roughly twice as likely as the general population to be without health insurance coverage, and rates of uninsurance are even higher for transgender individuals.”
A recent study published in Health Affairs found that the federal income tax burden on dependent employer-sponsored coverage for same-sex couples (as well as other factors) directly result in lower levels of insurance for partnered gays and lesbians as compared to their heterosexual counterparts. “Partnered gay men are less than half as likely (42 percent) as married heterosexual men to get employer-sponsored dependent coverage, and partnered lesbians have an even slimmer chance (28 percent) of getting dependent coverage compared to married heterosexual women,” the study found.
These disparities will likely decrease as the government implements the new health law, but as Baker and Krehely argue, policy makers should consider taking additional steps to ensure that all of the community’s health care needs are properly met.
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