Washington, D.C. — As the Senate Republicans rush to confirm a third U.S. Supreme Court nominee for President Donald Trump, much of the country has turned its focus on the fate of the Affordable Care Act (ACA), President Barack Obama’s landmark accomplishment that expanded access to health care for millions of Americans. For years, congressional Republicans have sought to overturn the law, either through legislation or judicial activism. Those efforts have largely been rebuffed, but California v. Texas—a case that will come before the Supreme Court next month—could be its undoing.
It is the most vulnerable Americans who stand to lose the most if the ACA is overturned. The LGBTQ community, communities of color, and people with disabilities have spent the past decade making progress toward increased health coverage, lowered medical expenses, protection for preexisting conditions, and added nondiscrimination protections.
Overturning the law would jeopardize health insurance for 20 million Americans and strip away protections for an estimated 135 million Americans with preexisting conditions, and those effects will only be amplified for the most at-risk populations.
An original analysis of new, nationally representative data from the Center for American Progress sheds light on the scale and scope of the harm that LGBTQ people would suffer should the ACA be overturned by the courts.
For instance, the ACA cut the uninsurance rate for LGBTQ adults making less than $45,000 a year in half, and 900,000 LGBTQ adults have health coverage through the insurance marketplaces that the law created. Medicaid expansion was critically important for narrowing the uninsurance rate, with nearly 2 million LGBTQ people covered through Medicaid. LGBTQ people in Medicaid expansion states are more than twice as likely to be insured than those in states without Medicaid expansion.
The law also provided nondiscrimination protections for LGBTQ individuals. These protections are essential for the health of millions of Americans: 36 percent of LGBTQ people who experienced discrimination in the past year reported avoiding doctor’s offices because of fear of further discrimination by their health care providers. Those figures rise precipitously when one narrows the focus on transgender Americans.
“Despite crucial gains in health coverage and benefits for LGBTQ communities under the ACA, transgender adults—particularly transgender people of color—continue to face substantial and unique discriminatory barriers to accessing health insurance and services,” said Caroline Medina, policy analyst for the LGBTQ Research and Communications Project at CAP and co-author of the column. “The data reveal both the depth of harm that LGBTQ Americans would encounter under the ACA’s repeal as well as the need to continue combating discrimination in health care settings. At this critical juncture, the ACA’s protections should be expanded, not undermined.”
In short, LGBTQ communities find their health and safety once again in the hands of the Supreme Court and a nominee who has already expressed her contempt for the ACA and her disinterest in the rights of LGBTQ Americans.
Read the column: “Repealing the Affordable Care Act Would Have Devastating Impacts on LGBTQ People” by Caroline Medina and Lindsay Mahowald.
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