Nearly a Million LGBT Adults May Lose Health Insurance by 2026 Due to Proposed Changes to the Affordable Care Act

Several studies have found that the Affordable Care Act (ACA), legislation passed by the Obama administration to extend health coverage to uninsured Americans, increased insurance coverage among LGBT adults.[i], [ii], [iii], [iv], [v], [vi] 

The Congressional Budget Office (CBO) estimates that changes recently proposed by Republicans, referred to as the American Health Care Act, would lead to higher uninsurance rates in the U.S. as a whole.[vii]  Based on the CBO’s estimates, we estimate that more than a half million LGBT adults would be uninsured in 2018 under the proposed changes to the ACA[1]. By 2020, the number of uninsured LGBT adults would increase by more than three-quarters of a million, and by 2026 would rise by nearly a million. Proposed changes to the ACA are likely to decrease coverage for low-income adults who are enrolled in Medicaid or who receive federal tax credits to purchase coverage in the health care marketplace, as well as by repealing penalties associated with the individual insurance mandate. Our estimates are conservative in that the ACA has had a positive impact on insurance coverage among LGBT adults that may exceed the coverage impact observed among non-LGB adults.[viii], [ix]

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[1] This estimate was based on information prepared by the Congressional Budget Office and the Joint Committee on Taxation on March 13, 2017 (https://www.cbo.gov/publication/52486), before amendments were made to the American Health Care Act on March 21, 2017, as well as percentage LGBT (4.1%) from the 2016 Gallup Daily Tracking Poll (http://www.gallup.com/poll/201731/lgbt-identification-rises.aspx.)

[i] Karpman M, Skopec L, Long S. “QuickTake: Uninsurance Rate Nearly Halved for Lesbian, Gay, and Bisexual Adults since Mid-2013.” Health Reform Monitoring Survey. April 2015. Available at http://hrms.urban.org/quicktakes/Uninsurance-Rate-Nearly-Halved-for-Lesbian-Gay-and-Bisexual-Adults-since-Mid-2013.html. Accessed March 22, 2017.

[ii] Gonzales, G & Henning-Smith, C. The Affordable Care Act and Health Insurance Coverage for Lesbian, Gay, and Bisexual Adults: Analysis of the Behavioral Risk Factor Surveillance System. LGBT Health. 2017. 4(1):62-67.

[iii] Gates, GJ. In U.S., LGBT More Likely Than Non-LGBT to Be Uninsured. GALLUP. August 2014. Available at http://www.gallup.com/poll/175445/lgbt-likely-non-lgbt-uninsured.aspx Accessed January 20, 2017.

[iv] Baker, KE, Durso, LE, Cray, A. Moving the Needle: The Impact of the Affordable Care Act on LGBT Communities. November 2014. Available at https://cdn.americanprogress.org/wp-content/uploads/2014/11/LGBTandACA-report.pdf. Accessed March 22, 2017.

[v] Kates, J, Dawson, L. Insurance Coverage Changes for People with HIV Under the ACA. The Henry J. Kaiser Family Foundation. February 2017. Available at http://kff.org/hivaids/issue-brief/insurance-coverage-changes-for-people-with-hiv-under-the-aca/. Accessed March 22, 2017.

[vi] Baker, KE, Durso, LE. Why Repealing the Affordable Care Act Is Bad Medicine for LGBT Communities. Available at https://www.americanprogress.org/issues/lgbt/news/2017/03/22/428970/repealing-affordable-care-act-bad-medicine-lgbt-communities/. Accessed March 22, 2017.

[vii] Congressional Budget Office.  March 2017. Cost Estimate: American Health Care Act. Available at https://www.cbo.gov/publication/52486.  Accessed March 22, 2017.

[viii] Karpman M, Skopec L, Long S. “QuickTake: Uninsurance Rate Nearly Halved for Lesbian, Gay, and Bisexual Adults since Mid-2013.” Health Reform Monitoring Survey. April 2015. Available at http://hrms.urban.org/quicktakes/Uninsurance-Rate-Nearly-Halved-for-Lesbian-Gay-and-Bisexual-Adults-since-Mid-2013.html. Accessed March 22, 2017.

[ix] Gonzales, G & Henning-Smith, C. The Affordable Care Act and Health Insurance Coverage for Lesbian, Gay, and Bisexual Adults: Analysis of the Behavioral Risk Factor Surveillance System. LGBT Health. 2017. 4(1):62-67.

 

 

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