A number of things will help us turn opportunity into reality in terms of health care for LGBT people in 2014. The first of these is the Affordable Care Act which will impact LGBT people in five ways:
Data collection: The ACA requires the Department 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 needs, educate clinicians about these, and reduce disparities.
Nondiscrimination protections: Public and private health insurers cannot discriminate on the basis of sexual orientation, gender identity or HIV status, eliminating a major barrier to care.
Prevention and wellness: Preventive services important to LGBT people will be covered by insurance as essential health benefits, including Pap tests, screenings for HIV , depression, and tobacco use.
Insurance market reforms: The Patient’s Bill of Rights phases out annual and lifetime limits on coverage, ends pre-existing condition exclusions, and ends arbitrary withdrawal of insurance coverage. These protections are especially important for transgender people and people living with HIV/AIDS.
New coverage options: Subsidies will allow millions of people, including almost 900,000 uninsured LGBT people in all 50 states, to afford to buy health insurance for the first time. And same-sex married couples, no matter in which state they live, can apply for and receive health insurance marketplace subsidies as a family.
Second, we are seeing tremendous interest in professional development around the provision of culturally competent care to LGBT people. The National LGBT Health Education Center is being asked to work with providers across the country in areas like Mississippi, Arkansas, Louisiana, the Dakotas, and Utah.
Last, of great significance is the great interest we see all over regarding appropriate care for transgender and gender variant people from young to old, and we think there is great opportunity to do more to insure access to quality care for transgender people in2014. Staff from The National LGBT Health Education Center travels the country providing technical assistance to health care providers and community health centers. We will continue that work in 2014. But we’ll do so in a climate of continuing positive change as the nearly one million LGBT Americans who are currently uninsured get access to care through the Affordable Care Act.
Harvey Makadon, MD is the Director of the National LGBT Health Education Center at The Fenway Institute.