Still need health insurance? The ACA is on your side


Due to multiple factors, members of the LGBT community generally have a harder time than most finding affordable, appropriate physical and mental healthcare. To help change that, the National LGBT Health Education Center at The Fenway Institute has teamed up with the Center for American Progress to enroll as many people in health insurance plans as possible.

The US has long been known for a health care gap, something the Affordable Care Act (ACA) aims to change. To get people enrolled, the new alliance is releasing a guide for healthcare providers to not only provide better care, but get more people in the LGBT community enrolled in the newly available plans.

The guide, “Optimizing LGBT Health Under the Affordable Care Act: Strategies for Health Centers ,” details five ways the ACA helps improve LGBT health: data collection, nondiscrimination protections, prevention and wellness, insurance market reforms, and new coverage options.

Only in recent years have studies been done on the health conditions that disproportionately affect the LGBT community, so very little data is currently available. One way the ACA plans to change that is by requiring the Department of Health and Human Services to include sexual orientation and gender identity in federal population health studies, which should provide more specific information on what issues are a concern and where, to start looking for solutions.

The ACA also offers protection from discrimination in regards to healthcare, meaning no one can be refused insurance for being LGBT, or charged more because of it. Individual states’ health Marketplaces, as well as Department of Health and Human Services’ Office of Civil Rights, are charged with handling complaints of such.

Especially of note is the fact that having a “preexisting condition”—such as living with HIV/AIDS or being transgender—can no longer be used for denial or revocation of care. However, transition-related care is not required to be covered. The explicit protection also means that people who have transitioned will not see their coverage legally revoked on the grounds of intentional misrepresentation or fraud, and healthcare providers are required to offer preventative screenings in accordance with a person’s anatomy, no matter what their listed gender is; MTF women, for example, generally still have prostates.

The ACA also places considerable emphasis on prevention, considering it an “essential health benefit.” Therefore, it requires that most insurance plans cover certain types of screenings without a co-pay, something that will have considerable benefit for the LGBT community; lack of said screenings is a large part of the healthcare gap. A 2009 study from the California Health Institute indicated that LGBT adults have higher rates of certain cancers than their heterosexual counterparts, but are less likely to have affordable access to screenings such as pap smears. Also included under the preventative care umbrella are STD tests and mental health screening.

Another longstanding barrier to healthcare for the LGBT community has been lack of legal recognition for their relationships; unlike their heterosexual counterparts, it has been difficult for LGBT families to get everyone covered under the same plan. Under the ACA, however, even couples living in a state that doesn’t legally recognize their relationship can get health insurance marketplace subsidies and coverage under a family plan. even has a search filter for same-sex couples looking for local coverage with domestic partner benefits.

Even with the ACA, finding appropriate and affordable healthcare plans might not be easy; the results of a study by the Center for American Progress showed that many low-income members of the LGBT community, especially transgender people, who are currently uninsured feel “stressed, frustrated, worried, and overwhelmed” about having to find a provider. Those who haven’t yet are encouraged to visit Out2Enroll for detailed, targeted information and help finding the healthcare plan that’s right for them.


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Just another multi-disciplinary writer and bundle of contradictions trying to figure out how to get the most out of life, and make a living while I'm at it.

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