Lesbian, gay, and bisexual adults report continued problems affording care despite coverage gains

Abstract

The uninsurance rate among lesbian, gay, and bisexual (LGB) adults has dropped since the Affordable Care Act (ACA) and legalization of same-sex marriage. Less is known about whether disparities in access to care and health outcomes have narrowed in LGB adults compared to their straight peers in the post-ACA era.We used data from three waves of the Behavioral Risk Factor Surveillance System to examine access to a personal doctor, affordability of care, type of health insurance coverage, and self-reported health in LGB adults in the period January 2014-February 2017 in thirty-one states that implemented the system's sexual orientation module. Compared to straight adults, more LGB adults reported avoiding necessary care because of cost and worse self-reported health outcomes, even if they had health insurance. More LGB adults reported having individually purchased insurance, which suggests that the repeal of the ACA's individual mandate may create challenges in the affordability of necessary care.