How Repealing Obamacare Will Hit the LGBT Community Extra-Hard

A repeal of the Affordable Care Act would mean the removal of vital protections for LGBT Americans
01/27/2017 11:01 am ET Updated Jan 29, 2017

Thanks Obama, for the inhaler, blood test results, and flu shot I was recently able to obtain. Because of the Affordable Care Act (a.k.a Obamacare), I’m getting better health care than ever, and so are millions of Americans. But what would happen if the ACA went away? Well, turns out that would be hazardous to everyone’s health ― especially for LGBTs.

You’re probably familiar with some of the things the ACA does, like protecting people with pre-existing conditions and keeping young people on their parents’ health plans. But it does some particularly important things for the queer community. That’s because LGBTs are less likely than straight people to be insured, and less likely to have insurance through their spouse. And even when queer people are insured, insurance companies are more likely to discriminate against them. So to fix that, the ACA set up a system in the Office of Civil Rights to make sure LGBTs get equal access to coverage. And sure enough, in just the first year since the ACA was enacted, the number of uninsured LGBTs decreased by 24%.

So now LGBTs are more likely to have health coverage, and less likely to have coverage denied. That’s a big deal, because there are a lot of health issues that disproportionately affect queer people. Of course, HIV is the big one, and the ACA provides for free HIV tests as a preventative measure. But it also supports health care like smoking cessation, which queer people are more likely to need. And screening for depression, which is of heightened concern for LGBTs. HPV, hepatitis, eating disorders, even breast cancer are more prevalent among certain queer populations. And the ACA helps people deal with all of those things so you don’t have to declare bankruptcy just because you got sick.

If the ACA is repealed, as Republicans are trying to do, not only would 32 million people lose health care, according to the Congressional Budget Office, but LGBTs would be disproportionately affected. And “disproportionately affected” is a phrase which here means “get sick and die.” For example, HIV treatment can cost thousands of dollars per month. Insurance companies that don’t want to pay for that treatment could just refuse to cover all gay people on the basis that gay men are more likely to be HIV positive. Or they could raise monthly premiums just for gays. Or they could create a lifetime cap, so you pay into their system and then as soon as you need expensive treatment, they drop you. All this was legal until the ACA banned it.

There are companies that cannot wait to go back to those bad old days. A religious hospital network called the Franciscan Alliance is already trying to obtain exemptions to ACA rules that protect queer people. And the state of Texas is suing the federal government on the Franciscan Alliance’s behalf. They’re named for St. Francis, by the way, who took a vow of poverty and cared for marginalized lepers, so I’m sure he’d be very proud of the work that’s being done in his name today.

But in thinking about the repeal of the ACA, St Francis might have some useful lessons. He was compassionate to everyone, including animals, which is why he’s often depicted as a Disney princess talking to birds. “A single sunbeam is enough to drive away many shadows,” is a teaching often attributed to him, meaning a little bit of good can go a long way. There’s never been a more important time for calling your representatives, organizing, marching, speaking out about why the ACA matters. It may seem unlikely that one person can change the world. But as the Franciscan Alliance’s namesake once said, “Start by doing what is necessary, then what is possible, and suddenly you are doing the impossible.”

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