GLBTQ Health Disparities and the Affordable Care Act

Percent of people without Health Insurance in Minnesota: GLBTQ vs All Minnesotans Before and After the Affordable Care Act

Percent of people without Health Insurance in Minnesota: GLBTQ vs All Minnesotans Before and After the Affordable Care Act

If you’ve attended a Minnesota Pride event recently, you’ve probably been asked to take the Rainbow Health Initiative (RHI) Voices of Health survey. The Voices of Health survey is an effort by RHI to document the health of Minnesota’s gay, lesbian, bisexual, transgender, and queer communities. If you have participated in this survey, congratulations! You are contributing to the advancement of GLBTQ health equity. The new 2015 survey is already available online at as RHI is trying to increase the number of surveys taken through online access and social media campaigns.

The Voices of Health data results show that health care professionals, community members, organizations, and policy makers need to address the significant health disparities in the GLBTQ communities. RHI uses this data to inform the Education and Training Program, advocate for GLBTQ health rights and inclusion, and create safe spaces for those seeking health care.

Data from the last three years’ RHI Voices of Health show that, when compared to non-GLBTQ individuals, GLBTQ individuals in Minnesota are more likely to report a history of anxiety, depression, or post-traumatic stress disorder, are less likely to have health insurance, and are more likely to use tobacco or abuse alcohol. Compounding these disparities is the fact that GLBTQ individuals often face discrimination when accessing care. More than one in ten GLBTQ individuals report having been discriminated against by a health care provider because of sexual orientation or gender identity in the last twelve months, and one in six report receiving poor quality care because of their sexual orientation or gender identity in the last twelve months.

Your health is one of the most important aspects of your life. However, the data is clear; GLBTQ communities are facing significant health disparities. Having the proper insurance and health care will improve your quality of life. These disparities will not change overnight, but getting covered and seeking GLBTQ culturally competent health care will go a long way in improving our communities’ health.

The Affordable Care Act (ACA), implemented through MNsure in Minnesota, is important to improving the health of GLBTQ communities. Since its implementation in 2013, the percentage of uninsured Minnesotans has dropped from 8.2% to 4.9%. However, GLBTQ Minnesotans tend to be uninsured at a higher rate than the general population, especially among GLBTQ people of color, lower income GLBTQ, and transgender individuals. According to the preliminary figures from the data collected by RHI’s Voices of Health survey, the uninsured rate for GLBTQ Minnesotans dropped from 15.9% in 2013 to 13.5% in 2014*.

Although, under the ACA, the overall uninsured rate for GLBTQ has dropped, the gap between non-GLBTQ and GLBTQ has gotten larger; despite policy changes in the Affordable Care Act should make that insurance more affordable and more inclusive for GLBTQ individuals. MNsure provides access to some affordable health plans and can offer tax credits to assist you with your premiums. Additionally, MNsure provides protections for consumers. You can no longer be denied coverage because a preexisting condition. You also cannot be denied coverage or charged a higher premium because of medical history, and there is no annual or lifetime dollar limits on coverage. The Affordable Care Act also bars insurance companies from denying someone insurance due to their sexual orientation, gender expression or gender identity; however, it is important to remember that some plans may have exclusions or restrictions around what procedures they cover, especially related to hormone therapy and gender reassignment surgery.

Before the Affordable Care Act, someone with a preexisting condition typically had to choose coverage solely based on how well a plan covered the care related to that condition. Now, new regulations prohibit insurance companies from denying coverage to people with preexisting conditions and on the exchanges, plans cannot include a person’s preexisting condition in the calculation of their rates. The only factors that can affect your premiums are your age, where you live, and whether you smoke. This means that people can look at a variety of plans and choose the one that works best for them, rather than picking one that will only cover treatment for their preexisting condition.

For example, when Angela** was researching her insurance options for 2015, she found a plan on the exchange that suited her target premium as well as what she’d prefer to pay for deductibles, coinsurances, and copays. Angela has a specific program and therapists who are helping her with an eating disorder treatment. In order to select the best option for her needs, Angela called the insurance provider for the plan that she had selected on the exchange. The plan she was considering did not have a wide enough network to include her eating disorder program. What happened next surprised her.

Angela** found that although she had previously been denied individual coverage, because her weight was considered a preexisting condition, the Affordable Care Act allowed her to enroll in one of the insurance provider’s individual plans. This plan includes her eating disorder program, has a premium that works within her budget and also has a lower deductible than she’s had in many years.

Open enrollment for 2015 health insurance coverage began on November 15, 2014 and ends February 15, 2015. MNsure is the Minnesota Affordable Care Act marketplace for residents to shop, compare, and choose health insurance coverage that meets their needs. It is also the only place to get financial assistance. Depending on household size and income, Minnesotans may qualify for low-cost public insurance programs or a discounted plan from a private insurance company.

There are three ways to get free enrollment assistance. You can call the MNsure contact center at 1-855-3-MNSURE (1-855-366-7873) and speak with trained specialists to answer questions. Visit an agent or broker. These trained and licensed professionals offer free face-to-face enrollment assistance and advice to help you select a plan. Or, visit a MNsure Navigator. Navigators are individuals from trusted organizations trained to provide free face-to-face applications and enrollment assistance.

A few organizations in Minnesota are trained and sensitive to the unique needs of GLBTQ communities. You can find these Navigators at the Minnesota AIDS Project, Family Tree Clinic, Planned Parenthood, and the Rural AIDS Action Network (outside of the Twin Cities metro). If you are looking for a provider, visit www.rainbowhealth/resources-for-you and search RHI’s Provider Directory.

*Official 2014 Voices of Health data will be released on February 16, 2015, visit or find us on Facebook and Twitter.

**Name changed to protect the identity of the individual.

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