Affordable Care Act Enrollment Assistance for LGBT

Affordable Care Act Enrollment Assistance for LGBT For Communities

A Resource for
Behavioral Health

This toolkit is designed to help behavioral health providers assist lesbian, gay, bisexual, and transgender (LGBT) people enroll in health coverage. Many LGBT people in the United States lack health coverage, and therefore often lack access to behavioral health services and could benefit from enrollment support. They may be unaware of new health coverage options under the Affordable Care Act that could affect their health outcomes.

Behavioral health providers can promote enrollment by educating patients about the law and directing them to appropriate resources for further assistance.

The Toolkit has three parts. Part 1 is a briefing document that provides background information on behavioral health issues affecting LGBT communities. It summarizes research on barriers that LGBT individuals may face when seeking health coverage.

Topics include the Affordable Care Act, responding to enrollment concerns, choosing an appropriate health plan, and finding providers who are sensitive to LGBT needs. It concludes with resources, most of them online, that provide additional enrollment support.

Part 2 is a slide deck that summarizes main points from the briefing document.

Part 3 is a Question-and-Answer brochure that health care practitioners can provide to LGBT patients.

Getting Ready to Get Covered:

A Resource for Behavioral Health Providers Offering Affordable Care Act Enrollment Assistance for the LGBT Community

A. Background

Many lesbian, gay, bisexual, and transgender (LGBT) individuals in the United States lack health insurance, are unaware of their new coverage options under the Affordable Care Act and would benefit from enrollment support. Behavioral health providers can promote enrollment by educating patients about the law and pointing them to appropriate enrollment resources.

This toolkit was developed to assist behavioral health providers who work with LGBT individuals. The toolkit’s four purposes are to:

1. Increase provider awareness of issues that particularly affect the LGBT population!

2. Provide information on key provisions of the Affordable Care Act.

3. Give specific considerations regarding enrollment for LGBT communities!.

4. Offer resources to support LGBT individuals who have questions or are ready to enroll.

Why Does It Matter?

There are an estimated 9 million LGBT Americans. Among those in the LGBT community who are low or middle income—those who make up to 400 percent of the Federal Poverty Level and who are therefore often eligible for financial assistance to gain coverage under the Affordable Care Act—one in three lack health insurance.

Because of discrimination, prejudice, and other factors related to social exclusion, LGBT individuals face elevated risk of behavioral health concerns such as depression, suicidal ideation, and substance misuse and abuse. LGBT youth, particularly those who experience rejection by their families, face especially high risk of depression and other behavioral health concerns, as well as high rates of homelessness.

The greater prevalence of behavioral health needs among LGBT communities—and the corresponding need for affordable, quality coverage that facilitates access to appropriate health care—highlights the importance of creating opportunities for outreach, education, and enrollment that are LGBT culturally competent and affirming.

Importance of Behavioral Health Providers

Behavioral health providers are uniquely suited to assist with providing information about health coverage options for LGBT individuals. As providers, you are skilled at developing trust-based relationships with your patients and are familiar with theories of behavior change that may be relevant to helping individuals assess the importance of health coverage and consider their enrollment options. Behavioral health providers are also more likely to be accustomed to working directly with health concerns that are particularly relevant to LGBT individuals.

B. Barriers to Health Coverage Enrollment

LGBT individuals face many barriers to obtaining health coverage. Some are shared with other groups, while others are unique.

LGBT individuals experience high levels of poverty. Nationwide, about one in five gay and bisexual men and one in four lesbian and bisexual women are living in poverty1 , and more than 25 percent of transgender Americans report an annual household income of less than $20,000.2

People in same-sex relationships often have difficulty obtaining a family policy to cover a partner or spouse. Among those who try, as many as 50 percent report encountering trouble and 75 percent report feeling discriminated against in the process.3 Difficulty accessing employer-sponsored insurance can result from a lack of LGBT-inclusive protections from employment discrimination in many states and on the national level. Following the 2013 Supreme Court decision regarding the Defense of Marriage Act, the U.S. Department of Health and Human Services issued guidance in March 2014 clarifying that plans offering family coverage to different-sex spouses must offer that coverage to legally married same-sex spouses as well.

Because states differ in their rules about the availability of spousal and other types of family coverage, there are still circumstances in which some coverage options may not be available to same-sex couples.

• Lack of interest in enrollment for transgender individuals may result from plan exclusions of coverage for medically necessary health care services related to gender transition, such as hormone therapy, surgical procedures, and mental health services. Transgender individuals’ access to preventive services may also be limited to those that are commonly associated with only one gender, such as Pap tests or mammograms.

• The majority of LGBT people are unaware that financial help may be available under the Affordable Care Act to assist people making up to $46,680 per year to afford coverage (this figure is  for a family size of one; the limit is higher in Alaska and Hawaii). Individuals also may not know that the law introduces new LGBT-inclusive nondiscrimination protections in health coverage and care, establishes a new Essential Health Benefit standard that requires many plans to cover mental and substance use disorder treatment, and prohibits plans from denying coverage on the basis of pre-existing conditions, including a behavioral health condition. In making the step from coverage to care, LGBT people may be unsure how to find LGBT-friendly providers. LGBT patients are more likely to establish effective therapeutic alliances with providers who demonstrate knowledge of, and sensitivity about, their communities and concerns, and research has found that substantial majorities of LGBT people agree that it is important for their providers to know about their sexual orientation and gender identity.

The next section presents a variety of resources to assist LGBT individuals in overcoming these barriers and enrolling in quality, affordable health coverage.



Click on the Blue Button Below for Instant Access!

Our 100% Money Back Guarantee:

If for any reason you decided within 30 days that “AFFORDABLE HEALTH CARE ACT ENROLLMENT ASSISTANCE FOR LGBT” isn’t for you, simply notify us by email and we’ll gladly refund your money – no questions asked. That’s our Ironclad Guarantee! The risk is entirely ours! You absolutely have nothing to lose!

Confirm Subscription

Your name and email will Never be shared, sold, or given to anyone.

We keep our subscriber’s privacy sacred. We do not sell or rent your personal information to other parties. What’s more you can always unsubscribe at any time!

Warmest Regards, Coyalita

Behavioral Health Rehabilitative Specialist & Addiction Counselor

Copyright © 2021-2024 All Rights Reserved Privacy PolicyEarnings DisclaimerTerms of UseContact Us

About Author

Share on Social Media