The Medicare Current Beneficiary Survey (MCBS), administered by the Centers for Medicare and Medicaid Services (CMS), is a nationally-representative, longitudinal survey of Medicare beneficiaries. People age 65 or older, some younger people with disabilities, and people with End-Stage Renal Disease are generally eligible for Medicare coverage. Data from MCBS is used to provide an accurate estimate of total Medicare health care costs and utilization, as well as to develop and monitor programs and initiatives intended for Medicare beneficiaries. The proposed revisions to MCBS would include collecting information on beneficiaries’ sexual orientation and gender identity (SOGI) and experiences of discrimination related to their LGBT status.
An estimated 11 million adults in the U.S. identify as LGBT, including 1.4 million transgender people. Estimates of older LGBT adults vary, with some research indicating that the population of LGBT adults over 50 will double to more than 5 million adults by 2030. Williams Institute research finds that older LGBT adults face unique challenges compared to their cisgender, heterosexual peers, including worse physical and mental health outcomes, barriers to receiving health care and social support, and experiences of discrimination based on their sexual orientation and gender identity.
The comment commends CMS for the proposed collection of data on LGBT Medicaid beneficiaries. Scholars document existing research on LGBT people, their experiences with discrimination, and observed disparities compared to non-LGBT people—including the impact of the COVID-19 pandemic. In addition, the comment provides support for collecting SOGI data in accordance with 2022 recommendations from an ad hoc panel of the National Academies of Science, Engineering, and Medicine.