The implementation of the Affordable Care Act, a.k.a. Obamacare, has had a huge impact on the LGBT community’s ability to access health insurance. According to a new report from the Center for American Progress, the uninsured rate among LGBT individuals who makes about $44,000 or less fell from 34 to 26 percent. This was actually a greater improvement than was found in the general population, where the uninsured rate dropped from 27 to 20 percent.
Obamacare particularly impacted those with lower incomes. Among LGBT individuals who make between $15,000 and $22,000, the uninsured rate declined by 18 percentage points, thanks to the insurance subsidies and Medicaid expansions provided by the law.
Not all LGBT people benefited the same, however. People who identify as bisexual only saw a 2 percent dip in uninsured rates, from 29 to 27 percent. Transgender people saw a dramatic 24 percent drop, but the uninsured rate among that community remains quite high at 35 percent.
According to the report, discrimination on the basis of sexual orientation and gender identity is still a significant barrier to LGBT people obtaining health insurance coverage. Because no federal law exists to protect LGBT people from employment discrimination, many enter unemployment or take low-wage jobs that do not include insurance benefits. Marriage inequality also limits LGBT individuals’ ability to access coverage through a spouse or partner. Only 38 percent of LGBT people in the studied income bracket had insurance through a partner benefit, compared to 58 percent of the general population.
LGBT people also experience discrimination from insurance carriers themselves. The report found that 8 percent of gay respondents experienced discrimination through a carrier, and another 8 percent struggled to obtain coverage because of a pre-existing condition, including a significant number who were denied coverage because of their HIV status.
There is good news on the horizon, though. New provisions will soon take effect that will allow Obamacare to serve LGBT people even better. Starting January 1, the law requires that any insurance plan that provides spousal or family coverage be offered to same-sex spouses under identical conditions, including couples who married in any state where it’s legal to do so, regardless of where they now live. State insurance commissioners are also increasingly issuing guidance prohibiting transgender exclusions in plans, helping increase access for that particularly vulnerable population.
A group of LGBT organizations have also proposed a Healthcare Bill of Rights, helping the community identify discrimination when it happens and encouraging them to find services that meet all their unique medical needs.
The report concludes that the first year of Obamacare’s implementation “shows great promise, but much work remains to be done to ensure that the benefits of the health reform efforts reach all who need them, including LGBT people and their families.” Read the full report for more insights about how the LGBT community has interacted with Obamacare.