Health reform drives coverage gains among LGB community

By Annette M. Boyle

A significant number of lesbian, gay and bisexual (LGB) adults gained health insurance under the Affordable Care Act--thanks in part to Medicaid expansion and the opening of insurance marketplaces, according to a recent Health Affairs study.

The Supreme Court ruling on marriage equality this summer also expanded access for LGB adults by enabling them to benefit from family health insurance coverage through employers, Medicaid, Medicare and the Department of Veterans Affairs, the study authors note. Now, nearly nine in 10 LGB adults, 88.9 percent, now have health insurance, compared to 78.2 percent before the Affordable Care Act, according to their analysis of data from the Health Reform Monitoring Survey.  

However, problems with access and affordability remain, with more than 40 percent of LGB adults reporting unmet needs for care because of cost. Yet more LGB adults had a usual source of care following ACA implementation, and they were also more likely to have a usual source of care than non-LGB adults.

What's more, a recently proposed rule from the federal government would prohibit sex and gender-based discrimination by any hospitals that accept Medicare or Medicaid payments and health plans that offer coverage through an ACA marketplace, a protection hailed by some advocacy groups. Yet some contend that health insurers still find ways to avoid covering gender-reassignment procedures, even though the government has banned the practice.

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