The lesbian, gay, bisexual and transgender (LGBT) community now has expanded access to health insurance, thanks in part to the Affordable Care Act and the rejection of the Defense of Marriage Act (DOMA), according to a new issue brief by the Kaiser Family Foundation.
Of the roughly 5.5 million LGBT individuals estimated to have incomes below 400 percent of the federal poverty level, one in three lack insurance and more than two-thirds have been uninsured for more than two years.
But nearly 390,000 uninsured LGBT individuals could qualify for Medicaid in expansion states, and about 1.12 million uninsured LGBT individuals could receive subsidies to help cover the cost of exchange coverage, according to the Kaiser Family Foundation.
And starting this month, the ACA prohibits insurers from charging more or denying coverage to anyone with pre-existing conditions, such as HIV infection or a transgender medical history, and from charging higher rates due to gender or health status in the individual and small group market, according to FierceHealthPayer's latest healthcare regulatory timeline.
Last spring, U.S. Department of Health & Services Secretary Kathleen Sebelius highlighted some other ACA provisions that reduce disparities among LGBT patients, including rules requiring Medicare and Medicaid-participating hospitals allow visitation rights for same-sex partners, and major national health surveys beginning to include data on LGBT groups.
Meanwhile, the Supreme Court ruling on DOMA in June 2013 gave new coverage options to the LGBT community, including dependent health coverage and family and medical leave. And under federal regulations, insurance marketplaces must recognize same-sex marriages and base tax credit eligibility on couples' income, the Kaiser Family Foundation report noted.
While the DOMA ruling does not require private companies to provide coverage to same-sex spouses, leaving that up to state policies, the Kaiser Family Foundation highlighted a five-fold increase in the number of U.S. employers offering at least one health plan that includes coverage of transgender services.
- here's the issue brief