Industry Voices—The ethical, business imperative to serve LGBTQ+ customers

What should we take away from the controversy surrounding Bud Light’s marketing campaign featuring transgender influencer Dylan Mulvaney? Some would argue that healthcare leaders should ignore issues of transgender rights and, more broadly, LGBTQ+ inclusivity.

We say that’s nonsense.

We assert that healthcare organizations have an obligation to put members of the LGBTQ+ community at the heart of their business strategies. First, because it is morally and ethically right. Second, because as we learned, it’s also good for business.

The healthcare struggles of LGBTQ+ people are well documented. Eight percent of the LGBTQ+ population say they’ve avoided medical care because they’ve experienced discrimination or disrespect in clinical settings.

Other LGBTQ+ people report discriminatory or bigoted remarks. They’ve been refused medications for HIV infection. Their clinicians refuse to even discuss gender transformation procedures and have little knowledge of the behavioral health complications many older LGBTQ+ Americans face as a result of open abuse and ridicule.

In addition, LGBTQ+ people often find themselves with no one to help them navigate their care needs. LGBTQ+ people are 2 to 3 times more likely than others to be childless in their senior years and this cohort of people often faces crushing isolation.

Faced with the stark reality of these experiences, SCAN created “Affirm,” a health insurance plan designed to meet the particular needs of the LGBTQ+ population. In addition to benefits offered to all of our customers, Affirm members receive care navigation support offered by Included Health, which helps connect LGBTQ+ community members with clinicians who understand and support this population’s unique healthcare needs.

In addition, Affirm members get PrP and HIV testing with no co-pays and lower co-pays for drugs that otherwise typically qualify as “specialty-tier” medications, including hormone-replacement therapies. We also offer reimbursement for legal fees that same-sex couples often face when pursuing medical power-of-attorney designations, unlimited access to behavioral health services and up to 40 hours of companionship or help with household chores.

We marketed Affirm under the tagline “creating a dignified health journey” in just two markets and relied on grassroots strategies to reach potential enrollees. We participated in local Pride events and advertised on a single LGBTQ+-focused radio station and in targeted local print publications. We introduced the plan’s offerings to independent brokers with LGBTQ+ clients and sought to make them champions of Affirm. One SCAN employee promoted Affirm among his network of friends and neighbors in Palm Springs, where he lives.

Our sales goals were modest. We hoped to enroll just 200 members. Roughly 300 joined Affirm during last year’s Medicare Annual Enrollment Period. Since then, hundreds more people have signed up and the number of enrollees stands at 600. Encouraged by these results, next year we will offer Affirm in three other California counties in both Southern and Northern California.

To be clear, we’ve experienced backlash from both within and outside our organization. A number of members posted derogatory comments on our social media pages. Some of our own employees wrote anti-gay slurs on our internal website. A medical group with whom we’d long partnered—and which had long been treating members who switched to Affirm—declined to specifically serve our Affirm members.

But truth be told, those headwinds are barely a breeze when compared to the gale force of our tailwinds. We’ve received overwhelming support from employees and health-system partners, and respect and deep gratitude from members - especially, of course, those in the LGBTQ+ community.

Fueled by these and other success stories, we are determined to further build out Affirm’s benefits to even more effectively serve this population, and we believe other health insurance plans and healthcare delivery systems should follow suit. That’s because this need — opportunity — will only grow in the near future. There are roughly 3 million LGBTQ+ Americans over the age of 50, and that number is expected to reach 7 million by the year 2030.

Yes, supporting their health is the right thing to do morally. But fortunately for the LGBTQ+ community as well as healthcare industry leaders, it also turns out to be a good business decision.

Sachin Jain, M.D., is the CEO of SCAN Group. Jill Selby is SCAN's senior vice president of product development, marketing and market expansion.