New research from the Williams Institute at UCLA School of Law finds that 13% of LGBT adults—approximately 1.8 million people—rely on Medicaid for their primary health insurance, compared to 7% of non-LGBT adults.
The U.S. House of Representatives is currently considering ways to cut Medicaid spending, including imposing work requirements for enrollees, reducing incentives for new states to expand Medicaid, stricter eligibility checks, tougher screenings for providers, and federal funding cuts for states providing coverage to undocumented immigrants.
Cuts to Medicaid funding would have a disproportionate impact on specific subpopulations of LGBT adults, including those living with low incomes, those raising children, individuals with disabilities, people of color, transgender adults, and cisgender lesbian and bisexual women.
Additionally, the proposed work and community engagement requirements for Medicaid enrollees will create further barriers to accessing Medicaid. Approximately 8 out of 10 LGBT adults on Medicaid either are working (46%), have worked in the past year (9%), are students (12%), or are unable to work (13%).
Researchers analyzed data from the 2021-2023 Behavioral Risk Factor Surveillance System (BRFSS) to examine reliance on Medicaid among LGBT adults, the impact of Medicaid expansion, and the potential effect of work requirements.
Results show that in states that have adopted Medicaid expansion under the Affordable Care Act, LGBT adults are nearly twice as likely to rely on Medicaid as their primary source of health insurance (15% vs. 8%) and half as likely to be uninsured (7% vs. 16%) compared to LGBT adults in states that have opted out of the expansion.
“Medicaid plays a critical role in providing access to health care for vulnerable LGBT populations, who face higher levels of poverty and disability than non-LGBT people,” stated lead author Brad Sears, Distinguished Senior Scholar of Law and Policy at the Williams Institute. “Any proposals to restrict Medicaid eligibility and cut benefits must take into account the effects on sexual minority women, LGBT people of color, and transgender individuals.”
Additional Findings
- Medicaid is the primary source of health insurance for
- 2 million lesbian and bisexual women
- 1 million LGBT adults living with a disability
- 560,000 LGBT parents with children under 18 in their households
- 390,000 cisgender gay and bisexual men
- 180,000 transgender adults
- One in four LGBT adults (26%) who live in households with incomes under $35,000 rely on Medicaid as their primary source of health insurance, compared with 5% of those with higher household incomes.
- Almost one in five LGBT adults (19%) with children rely on Medicaid, compared with 10% of LGBT people without children at home.
- LGBT adults with a disability are twice as likely to rely on Medicaid as LGBT adults who are not disabled (18% vs. 9%, respectively).
- Cisgender lesbian and bisexual women are over twice as likely to rely on Medicaid as cisgender gay and bisexual men (17% vs. 7%).
- Sixteen percent of LGBT adults of color rely on Medicaid for their primary health insurance, compared to 11% of white LGBT adults.