The Affordable Care Act and LGBT Americans
On March 23, 2010, President Obama signed the Affordable Care Act and set into motion an effort that will help give all Americans, including lesbian, gay, bisexual and transgender (LGBT) Americans, more control over their health care. Through these new reforms, LGBT Americans will have better access to stable, affordable health insurance and high quality health care.
New Coverage Options
There is some evidence suggesting that at least a portion of the LGBT community is disproportionately uninsured. This makes the new coverage options under the Affordable Care Act that much more important to them. The Affordable Care Act is making new coverage options available to Americans, including those without access to coverage through a domestic partner or employer and those with pre-existing health conditions:
- Already, qualifying Americans who are uninsured due to a pre-existing health condition have access to health insurance at an affordable rate through Pre-Existing Condition Insurance Plans.
- Young adults are able to remain on a parent’s health plan until they turn 26 if the plan covers dependent children and if coverage isn’t offered to them through their job.
- In 2014, the Medicaid program will be expanded to cover Americans with income at or below 133% of the federal poverty level. This expansion will increase access to care for low-income adults.
- Also in 2014, Affordable Insurance Exchanges, new competitive insurance marketplaces, will be established where millions of Americans and small businesses will be able to purchase affordable coverage and have the same choices of insurance that members of Congress will have. Tax credits will help middle class families afford health insurance.
New Patient Protections
New benefits will make it easier for consumers to get and keep their health coverage. For example, the Affordable Care Act prohibits insurance companies from refusing coverage to, or limiting the benefits of, children (under age 19) because of a pre-existing medical condition. In 2014, discriminating against anyone with a pre-existing condition will be illegal. And the law prohibits insurance plans from canceling an individual’s coverage just because of a mistake on his or her paperwork.
LGBT individuals have encountered discrimination in the health care system for decades, and many studies have shown that LGBT people are affected by chronic disease at a higher rate than straight people. The new law has already made significant progress toward ending some of the worst insurance company abuses and helping ensure that LGBT Americans have access to coverage when they need it most. For example, the Affordable Care Act ends lifetime dollar limits on key benefits and restricts annual dollar limits until they are ended in 2014, allowing for long-term comprehensive treatment of chronic diseases.
In addition, the federal website designed to help all consumers find the health insurance best suited to their needs makes it easy to locate health insurers that cover domestic partners. HealthCare.gov's insurance and coverage finder now includes a “same-sex partner” filter, allowing same sex couples to eliminate plans which would not cover both people from the list of plans available in their area. Consumers looking for information on domestic partner coverage will also have access to HealthCare.gov’s regular features, such as the ability to sort based on the enrollment, a plan’s out-of-pocket costs or other categories. The same-sex partner filter is also available for small employers looking for information on the small group market.
Preventive Care for Better Health
The Affordable Care Act is taking significant steps toward improving access to preventive care. Non-grandfathered health plans now must cover recommended preventive care services without charging deductibles, co-payments or co-insurance.
In addition, the Affordable Care Act is funding preventive efforts for communities, including millions of dollars to use evidence-based interventions to address tobacco control, obesity prevention, HIV-related health disparities, better nutrition and physical activity. The Department of Health and Human Services is working with community centers serving the LGBT community to employ proven prevention strategies.
Improving Care and Fighting Disparities
The Affordable Care Act is making other investments that will help address health disparities experienced by the LGBT community. Funding is going toward building a more diverse and culturally competent health care workforce, as well as investing in community health centers to serve up to 20 million more patients. And through increased research and data collection on health disparities, policymakers will have the knowledge and tools they need to continue to address health issues in LGBT communities.
Small Business Tax Credits
The Affordable Care Act helps small business and small tax-exempt organizations afford the cost of providing health coverage for their employees. Americans who own a small business with fewer than 25 employees and provide health insurance may qualify for a small business tax credit of up to 35% (up to 25% for non-profits) to offset the cost of the insurance. This will make the cost to small employers of providing insurance much lower.
Historically, people living with HIV and AIDS have had a difficult time obtaining private health insurance and have been particularly vulnerable to insurance industry abuses. Currently, fewer than one in five (17%) people living with HIV have private insurance and nearly 30% do not have any coverage. The Affordable Care Act makes it easier for people living with HIV/AIDS to get coverage through the Pre-Existing Condition Insurance Plans. The ban on pre-existing condition exclusions will extend to all Americans in 2014, along with expanded Medicaid eligibility, the creation of Affordable Insurance Exchanges, and new tax credits for middle class families to help them afford insurance.
People with HIV/AIDS also face barriers to obtaining care from qualified providers. Consistent with the goals of the President’s National HIV/AIDS Strategy, the Affordable Care Act makes considerable strides in addressing these concerns and advancing equality for people living with HIV and AIDS. Investments in prevention, as well as improving care coordination, will help people living with HIV/AIDS get the treatment they need.
To learn more about the new benefits and cost savings available visit www.HealthCare.gov. A first-of-its-kind website, HealthCare.gov helps consumers make informed decisions about health care coverage by offering easy-to-understand information about which health plans are available in a given area, how much they cost, what they cover, and additional information tailored to specific needs.
Posted on: January 25, 2011
Last updated: February 17, 2012