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Equal care for all: Kathleen Sebelius, Health and Human Services secretary, says the LGBT community will be “hugely impacted” in a positive way by the Affordable Care Act.
Equal care for all: Kathleen Sebelius, Health and Human Services secretary, says the LGBT community will be “hugely impacted” in a positive way by the Affordable Care Act.

An issue of LGBT equality.
by Randall Ellis

Community leaders from across the country gathered at the White House on September 12 to learn how they can help hundreds of thousands of uninsured LGBT Americans get health care coverage under the Affordable Care Act (ACA). The briefing featured remarks from Valerie Jarrett, senior advisor to the president; Kathleen Sebelius, Health and Human Services secretary; and LGBT health-care and health insurance reform experts from across the country.

On the same day that these Obama administration officials were touting the advances in LGBT rights over the past five years and policy wonks were explaining how the LGBT community would benefit under “Obamacare,” Republicans in the United States House of Representatives were busy with their fortieth attempt to derail or repeal the historic health reform law.

Secretary Sebelius, addressing LGBT leaders who were gathered at the briefing as well as a wider online audience, seemed confident that the House effort would fail. “Thanks to all of you, this law is now a reality, and it is going to happen in spite of some of the best efforts of our friends at the Hill,” she told the crowd. “This is what we call a law. It was passed. It was signed. It was upheld by the Supreme Court. And the president got re-elected. This is a law, and the people are entitled to these benefits.”

As Sebelius stressed the importance of making sure LGBT Americans know their rights, responsibilities, and options under the ACA, she also stressed President Obama’s firm belief that health-care reform is an essential part of the fight for LGBT equality. “Here is the fact you all need to keep in mind,” she said. “One in three LGBT adults in America doesn’t have health insurance. We are talking about a community that can be hugely impacted by what’s about to happen.”

Insurance Inequalities

Like many people across the country, LGBT Americans have often struggled to get the health care they need, when they need it. The HIV/AIDS epidemic is a constant reminder to our community that adequate health care can literally mean the difference between life and death. Yet too often, barriers like the lack of insurance stand between the LGBT community and good health.

Research commissioned by the Center for American Progress not only shows that LGBT Americans lack health insurance at higher rates than their heterosexual counterparts, but that being uninsured results in more disparities. Because not all LGBT families are recognized under the law, employer-based health insurance is not always an option for spouses or partners, resulting in higher costs to obtain health insurance for our families. High numbers of LGBT Americans also report putting off getting care because it is too expensive.

LGBT individuals have encountered discrimination in the health-care system for decades, and many studies have shown that LGBT people are affected by chronic diseases, such as breast cancer and HIV/AIDS, at a higher rate than other Americans. Getting access to health coverage is indisputably an LGBT equality issue.

Improving LGBT Access to Care

The ACA makes investments that will help address health disparities that exist within the LGBT community. Funding is in place to promote a more diverse and culturally competent health-care workforce, and to support community health centers such as Houston’s Legacy Community Health Services. Through increased research and data collection on health disparities, policymakers will have the knowledge and tools they need to continue to address the health needs and concerns of LGBT people.

Starting in 2014, the ACA prohibits insurers from denying coverage or charging a higher premium based on pre-existing conditions, including HIV or AIDS. The law also prohibits insurers from charging someone more because of gender, sexual orientation, or gender identity. The ACA will help ensure that LGBT Americans will receive ongoing treatment of chronic diseases by ending lifetime dollar limits on key benefits, as well as restricting the use of annual dollar limits.

Under the ACA, health insurance plans will also have to provide preventive care, including annual checkups, mammograms, HIV testing, cancer and diabetes screening, and vaccinations—all without co-pays or deductibles.

The Out2Enroll Campaign

To access all of these benefits, people must have a health insurance plan. Uninsured Americans can find coverage in the online marketplaces that are scheduled to open on October 1. The open enrollment period runs until March 31, 2014.

To encourage LGBT Americans to sign up for the new health insurance plans under the ACA, the White House briefing also announced an outreach effort aimed at uninsured LGBT Americans.

Out2Enroll will work at both national and state levels to link LGBT communities with their new coverage options under the health reform law. The centerpiece of the campaign is a website—out2enroll.org—that is tailored to LGBT community concerns and includes information about key issues such as same-sex partner coverage, transgender-inclusive coverage, and LGBT-inclusive discrimination protections. Out2Enroll will also work with partners such as Enroll America, Community Catalyst, consumer health advocates, health centers like Legacy Community Health Services, and LGBT equality organizations to host regional forums and conduct state-level advocacy campaigns to educate LGBT communities about available coverage and to encourage enrollment through the online health insurance marketplaces.

The Out2Enroll campaign will launch on October 11, National Coming Out Day—an observance created to raise awareness of and empower the LGBT community. This day advocates something simple, yet elusive—that people need the freedom to be who they are. That freedom won’t be fully achieved until the LGBT community feels it is being served by the nation’s health-care system.

Legacy Community Health Services will have trained staff members available throughout the clinic on October 11 to assist anyone who is interested in learning about their health insurance options under the Affordable Care Act. October 11 will be a great opportunity to show your pride and help raise community awareness about the importance of health care as an LGBT equality issue. Since open enrollment will run until March 31, 2014, there is plenty of time to explore and understand your options.

For more information about Out2Enroll and to learn more about supporting efforts to connect every American with appropriate health insurance coverage, visit out2enroll.org.

Randall Ellis is Vice President of Public Affairs for Legacy Community Health Services.



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