How has Obamacare Helped Queer People?

The Affordable Care Act (ACA or colloquially termed ‘Obamacare’) has now defied the odds within America—passing judicial review, congressional arguments, multiple failed Republican efforts to repeal the ACA, and the list continues. The Clinton Administration, and other past presidents, have attempted to pass some form of universal healthcare or reform, with little to no success. The Obama Administration’s push to enact the Affordable Care Act through congress was based primarily within contentious political deals, and not focused on policy outcomes. Though policy elements of the ACA were significantly debated and reformed from it’s original, the passage can be linked to the Obama Administrations aims to keep the debates and policies transparent and open to reforms, President Obama’s political capital, and maintaining congressional ownership of the ACA with executive support and oversight.¹

The ACA has helped millions of Americans to gain access to healthcare, especially within states that have expanded their Medicaid programs under the ACA; however, the ACA also comes with its disadvantages. Liberals and progressives, especially in the House, found the concessions made to Republican demands, such as eliminating a public option, left many dissatisfied, especially the general public.²This resulted in President Obama’s approval rating plummeting, as his political capital became significantly depleted.

Although many were dissatisfied, there are numerous positive outcomes and results that have helped individuals to receive affordable healthcare. This is especially true for marginalized groups of Americans, as is evident within the research surrounding the positive results the ACA has had on the Queer community (for the purpose of this paper the Queer or LGBTQ+ community will be used as a blanket term or phrases referring to Lesbian, Gay, Bisexual, Transgender/Trans* individuals and those that identify with gender and sexuality marginalized groups). Although only one section of the ACA discusses LGBTQ+ individuals, research has shown that there has been significant leaps and bounds for Queer individuals in gaining access to healthcare and higher quality care as a result of the passage of Obamacare, regardless of the state you live in.

Prior to the passage of the ACA, many Queer Americans were among a larger part of society that were unable to obtain quality healthcare, both institutionally through insurance coverage, and clinically as the treatment of LGBTQ+ patients were substantially lower than heterosexual and cisgender patients. There are significant challenges that Queer people face within receiving or gaining access to healthcare: discrimination, stigma, rejection from their respective communities (racial, cultural, familial, etc.), subpar coverage for needed services by health insurance providers, and inequality in the workplace; furthermore, outright denial of care because of an individual’s sexual orientation or gender identity was, and still is, not uncommon.³

The Huffington Post reported in 2013 that the Affordable Care Act improves the healthcare treatment of LGBTQ+ individuals in five specific regions:

“i. Nondiscrimination protections: Public and private health insurers are prohibited from discriminating on the basis of sexual orientation, gender identity or HIV status.

ii. Insurance market reforms: The Patient’s Bill of Rights phases out annual and lifetime limits on coverage, ends preexisting condition exclusions, and ends arbitrary rescission of insurance coverage. These protections are especially important for transgender people and people living with HIV/AIDS.

iii. Prevention and wellness: Certain preventive services particularly important to LGBT people will soon be covered by insurance as Essential Health Benefits, including HIV testing, depression screening, and tobacco use screening.

iv. New coverage options: Subsidies will allow millions of working-class people, including LGBT people, to afford to buy health insurance for the first time.

v. Data collection: The ACA authorizes the Secretary of Health and Human Services to expand the collection of sexual orientation and gender identity data on national health surveys that help us better understand LGBT health and prioritize spending and research priorities.”4

These five specific regions of improvement allow for Queer individuals to gain greater access to quality healthcare and health coverage. In a blog post posted by the White House it is added that the ACA provides LGBTQ+ patients with the guarantee of no lifetime limits on coverage for those that have chronic illnesses such as HIV/AIDS, nor can you be charged a higher premium due to your sexual orientation or gender identity 5.

Moreover, with the ACA insurance mandate that disallows insurance providers to deny coverage based upon pre-existing conditions, LGBTQ+ individuals will be able to receive coverage regardless of common illnesses within the Queer community such as HIV/AIDS and mental health issues 6. With the expansion of Medicaid in some states, millions of American citizens that are at or near the poverty are able to receive healthcare that was previously unavailable to them. Although, it should be noted that in states that have decided to not expand Medicaid this gap still exists 7,8. In addition, with the expansion of marital rights for lesbian and gay couples through judicial review and Supreme Court cases, there are further protections for queer patients, such as hospital visitation rights, and end of life decisions for legally married spouses 9. Through the implementation of the Affordable Care Act there is greater access to higher quality healthcare for both cisgender, heterosexual and LGBTQ+ patients.

The ACA provides Queer individuals with protections and rights that were previously unavailable under the previous healthcare laws. Additionally, with the expansion of marital rights for gay and lesbian couples there is further access to healthcare protections that were denied previously. This includes hospital visitation rights, end of life decisions, preventative car, greater coverage for chronic illnesses that disproportionately affect the LGBTQ+ community, and coverage regardless of pre-existing conditions. It should be noted that the ACA is far from perfect, and still leaves millions of Americans without proper coverage or access to coverage; however, through the ACA millions of Queer Americans now have greater access to higher quality healthcare and coverage mostly as a result of expanded patient’s rights and protections. Though the ACA only discusses coverage and healthcare for LGBTQ+ in one section of the much larger bill, it has had a positive impact for millions of Queer Americans.

Footnotes

1: Porter, R., & Darnell, S. (2012, November 26). A Prescription for Change: The 2010 Overhaul of the American Healthcare System [Scholarly project]. Retrieved from http://case.hks.harvard.edu/a-prescription-for-change-the-2010-overhaul-of-the-american-health-care-system/

2: Ibid.

3: Beamesderfer, A., Dawson, L., Kates, J., Ranji, U., & Salganicoff, A. (2015, July 30). Health and Access to Care and Coverage for Lesbian, Gay, Bisexual, and Transgender Individuals in the U.S. [PDF]. The Henry J. Kaiser Family Foundation.

4: Cahill, S., & Mackadon, H. (2013, September 06). The Affordable Care Act: Real Benefits for LGBT People. Retrieved February 08, 2016, from http://www.huffingtonpost.com/sean-cahill/the-affordable-care-act-real-benefits-for-lgbt-people_b_3867921.html

5: Heinz, M., & Raghavan, G. (2013, December 17). Top Five Affordable Care Act Benefits for the LGBT Community [Digital image]. Retrieved February 7, 2016, from https://www.whitehouse.gov/blog/2013/12/17/how-obamacare-helps-lgbt-community

6: Redman, L. F. (2010, Summer). Outing the Invisible Poor: Why Economic Justice and Access to Health Care is an LGBT Issue [PDF]. Georgetown Journal on Poverty Law and Policy.

7: Ibid.

8: Porter, R., & Darnell, S.

9: Beamesderfer, et al.

Like Peculiar People on Facebook: