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Every American deserves access to affordable, high-quality care and health coverage — embracing the individual qualities that make us who we are. For some Americans who are LGBTQIA+, discrimination can keep them from getting the care they need when they need it. Health insurance providers agree: Everyone should have an equal opportunity to thrive and achieve their best health.
For some Americans who are LGBTQIA+, discrimination — which the Human Rights Campaign recently escalated to a state of emergency — can keep them from getting the care they need when they need it. People who are LGBTQIA+ also face more health disparities linked to social stigma. According to a 2022 Center for American Progress (CAP) study:
- More than one-in-five LGBTQIA+ adults reported postponing or avoiding medical care in the past year due to disrespect or discrimination by providers, including more than one-in-three transgender or nonbinary individuals.
- Approximately one-in-three LGBTQIA+ adults reported encountering at least one kind of negative experience or form of mistreatment when interacting with a mental health professional in the past year. That includes four-in-10 LGBTQIA+ people of color and more than one-in-two transgender or nonbinary individuals.
Further, in a 2021 U.S. Census Household Pulse Survey, 38% of LGBTQIA+ respondents reported experiencing depression – a dramatically higher rate than the 16% among non-LGBTQIA+ people.
We also know that health care includes more than just a person’s clinical needs. The same Household Pulse Survey found that 13% of adults who are LGBTQIA+ suffered from food insecurity during the pandemic, compared to seven percent of adults who are non-LGBTQIA+.
Progress, but much more to do
The 2015 Supreme Court decision recognizing same-sex marriage prompted more equitable coverage for LGBTQIA+ couples, as detailed in a new study. Further, the Affordable Care Act’s provisions have supported dramatic increases in the percentage of LGBTQIA+ adults with access to a usual source of health care. As reported recently in Axios:
- “Disparities in coverage started to decline in 2014, when the main coverage provisions of the Affordable Care Act took effect.
- By 2017–2019, coverage rates for LGBTQ[IA+] adults were comparable to those of non-LGBTQ[IA+] adults, although significant disparities in access remained.
- Partnered LGBTQ[IA+] adults were slightly more likely to have health insurance coverage than single individuals by 2019.”
Caring for LGBTQIA+ Patients
We know there is much to be done to combat obstacles to health care and ensure affordable, culturally competent treatment is available for those who need it most. Insurance providers provide access to health services and medications that are often needed by people who are LGBTQIA+.
For example, insurance providers help cover access to drugs for Americans who are at risk of exposure to HIV or are managing HIV infection — and insurance providers fight for policies to help lower the rising costs of these drugs. Last year, Big Pharma raised prices on two popular HIV-management drugs by 5.6%.
AHIP strongly supports ensuring that appropriate gender-affirming care is available and accessible to enrollees and that it reflects evidence-based guidelines and recommendations.
Many health insurance providers, including Aflac, Cigna, CVS Health, and Kaiser Permanente, are members of the Human Rights Coalition’s Business Coalition for Equality. The coalition supports the Equality Act, which would ensure that Americans who are LGBTQIA+ are afforded the same protections as any other protected group.
Here are other, unique ways health insurance providers are making a difference:
- Cigna established a national medical director role focusing on LGBTQIA+ health and well-being and provides training and resources to staff and medical professionals on health issues and disparities. The company also expanded access to transgender care and published a new resource to help transgender members care for their whole health and find providers to work with at every stage of their journey.
- CVS Health is highlighting resources to support the mental well-being of LGBTQIA+ individuals and those who support them. The company works with The Trevor Project and the Human Rights Campaign to improve health equity.
- Point32Health offers advice and links to resources on how to support people who are LGBTQIA+ who have been impacted and isolated by the COVID-19 crisis. Noting that transgender individuals often face discrimination and other difficulties accessing care, the organization has a transgender health services team that helps providers and members navigate their care.
- SCAN Health Plan offers a new Medicare Advantage plan that specifically addresses the needs of people who are LGBTQIA+. It includes benefits such as lower copays on particular prescriptions (such as HIV treatments and gender-affirming hormone treatment), and care navigation services.
Achieving health equity requires valuing everyone equally. Learn more about health insurance providers’ work to address issues on social determinants of health here.