Health & WellnessNews

When It Comes to LGBT Healthcare, There’s Still Work To Be Done

By Mimi Garcia

This month marks the 46th anniversary of the Stonewall Riot in New York City, what many see as the catalyst to the battle for legal and civil rights for the LGBT community. In the last four decades LGBT people have made many strides, including for legal rights and acceptance. But, unfortunately, one of the areas where there is still a lot of work left to do is in access to healthcare.

According to the Urban Institute Health Policy Center, the rate of uninsured lesbian, gay, and bisexual (LGB) adults nationwide was cut nearly in half since the middle of 2013. Between June 2013 and March 2015, the number of LGB adults without insurance coverage decreased from 21.7 percent to 11.1 percent, according to the center. This is great news.

In the greater Houston area, 26.5 percent of the population remains uninsured. It is estimated that nearly half of the LGBT population account for that number. This is not such great news.

The reasons for such high rates of uninsured among LGBT people are numerous.

LGBT individuals and their family members are less likely to be out to their healthcare provider, hampering the care they receive. A lack of culturally competent trained providers who understand the healthcare needs of LGBT individuals makes it even more difficult for LGBT Houstonians to get medical care in a setting where they feel safe.

Lesbian and bisexual women are twice as likely—29 percent compared to 16 percent of heterosexual women—not to have a primary care physician. They are also four to 10 times less likely to have a Pap smear or well-person exam, even though they have the same risk as heterosexual women for diseases like HPV and cervical cancer. Because early detection is one of the greatest predictors of survival of cervical cancer, the lack of preventive screenings can make the difference between life and death.

But it is not all doom and gloom. Progress is being made.

The Affordable Care Act (ACA) has done a lot to remove some of these barriers, and helped make health insurance coverage and healthcare available to people who have never had the opportunity before. The ACA has made quality, affordable health insurance available to millions of Texans.

In addition to financial help to pay for insurance, the ACA included specific benefits and protections for the LGBT community that helped expand access to health coverage.

Plans sold through the Health Insurance Marketplace provide key protections, including that no one can be denied health coverage because of their sexual orientation, gender identity, or gender expression. Preventive exams like annual well-person exams, Pap smears, colonoscopies, diabetes screenings, mammograms, and other exams are available without a co-pay. In addition, no one can be denied coverage for pre-existing conditions—including HIV or cancer. These are historic new protections for the LGBT community.

All plans must cover 10 essential health benefits, such as prescription medicines, emergency room visits, and doctor’s visits. Lifetime and annual caps on coverage are now prohibited, which means if you do get sick with something serious like cancer, you can’t be cut off because treatment is expensive.

Transgender individuals can no longer be denied the free preventative services they need—regardless of their sex assigned at birth, their gender identity, or their recorded gender.

The ACA also allows for all legally married couples to enroll in a plan through the Marketplace. This applies to all same-sex couples even if they live in a state that doesn’t recognize same-sex marriage, such as Texas.

While there is still work to be done, progress has been made. And education is key in getting the word out about the ACA and the coverage that is available to LGBT individuals. This month, as we celebrate PRIDE in Houston, it’s a good time to take pride in your health and well-being and take advantage of all the ACA has to offer.

Need health insurance? Find out where to get in-person help enrolling in health insurance at

Mimi Garcia is the Texas State Director for Enroll America.


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