Millions of people rely on the Affordable Care Act—also known as Obamacare—and you’ve probably heard about some of its best features, like allowing young people to stay on their parents’ plans, free preventative care and no more discrimination against people with pre-existing conditions.
But you might not have heard that the law also has some provisions that are crucial to the health of LGBTQ people. In fact, if the Republican plan to overturn Obamacare without a replacement goes through, it means that millions of people will lose coverage in a health care disaster with will have a disproportionate impact on the queer community.
Unique Health Challenges for LGBTQs
That’s because queer people face unique health challenges. For example, before the ACA was passed, queers were more likely to be uninsured, and to be unable to access insurance through their partners. (That’s changed now because of the nationwide legalization of marriage equality—but if Republicans have their way, that will be overturned as well.)
In addition, queer people are more likely to face discrimination from their insurance companies.
And that’s a big problem, because certain LGBTQ populations are at heightened risk for health problems. There’s HIV, as well as other sexually transmitted infections. But eating disorders, smoking, and even breast cancer is more prevalent in certain queer groups, so unfettered access to health care is particularly urgent.
Obamacare Solved a lot of Problems
So what makes the Affordable Care Act such an effective tool for addressing queer health? A number of factors: First, it set up an enforcement mechanism with the Office of Civil Rights to ensure that all people have equal access to coverage. It also enabled states to sue insurance companies for discrimination, such as when the insurance company Humana curbed access to care for people with HIV.
The Affordable Care Act also banned numerous practices that harmed queer people. Not only is it illegal now for insurance to discriminate against people on the basis of sexual orientation, but they also cannot be refused coverage on the basis of having one of those conditions that are more prevalent with LGBTQs. In addition, insurance companies can no longer impose lifetime caps that meant people would be dropped as soon as they needed coverage most.
Republican Plans Would Devastate the Queer Community
It’s important to note that the Republican plan to gut the ACA without providing any meaningful replacement would be devastating to the queer community. It’s hard to estimate just what the impact would be, beyond millions of people losing coverage and premiums rising astronomically (according to the nonpartisan Congressional Budget Office). But because queer people encounter more problems accessing health care and have unique medical needs, it’s likely that the negative impact will be profound and long-lasting.
But there are some groups that is likely to benefit handsomely from the surge in sick and dying queers: insurance companies and the medical industry. Groups like the Franciscan Alliance (also known as Franciscan Health) are already trying to obtain exemptions to the Affordable Care Act’s nondiscrimination protections. They want the ability to turn away certain patients they don’t approve of—and the ACA is the only thing standing in their way. For now.