By Menina Skelly, CCHI Policy Intern

As sexual and gender minorities, members of the Lesbian, Gay, Bisexual and Trangender (LGBT) community have experienced a long history of discrimination and social stigma. Because of this very little health research has been done about their health, rendering them undercounted and understudied. However, this recently changed for Colorado with the release of the report “Invisible: The State of LGBT Health in Colorado” by the One Colorado Education Fund. Findings from the report revealed that issues of affordability, access and quality confront LGBT Coloradans, as well as challenges in accessing LGBT-friendly care from providers. Members of the LGBT community in Colorado reported hiding their sexual orientation or gender identity in order to be treated with respect by health-care professionals.

Existing data from both the One Colorado Report and other studies reveals that LGBT individuals experience a higher rate of health disparities and greater discrimination in health care settings throughout their lives. There are many reasons for these inequities. A lack of cultural competence about the LGBT community on the part of health care providers, health educators, and health policymakers results in various barriers to LGBT individuals’ health care. Legitimate fear of discrimination and prejudice, as well as past negative experiences in the health care system, often cause LGBT individuals not to seek out health care. Cost and discrimination in employment and relationship recognition also result in barriers to health insurance coverage for many LGBT individuals. Furthermore, fewer financial and community resources exist to target the health issues facing LGBT communities and their families. Learn more with the Institutes of Medicine Report: The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.

An Important Step: The Affordable Care Act and LGBT Americans

A variety of Affordable Care Act (ACA) measures will help to improve the health and well being of the LGBT community. These include:

  • Collection of more data on a range of health disparities, including those associated with sexual orientation and gender identity.
  • In 2014, Medicaid will expand coverage to many lower-income Americans (all Americans under 138% of the federal poverty limit), including LGBT Americans. Currently, most state Medicaid programs only cover certain populations like children, pregnant women and people with disabilities. This has left much of the low-income LGBT community without access, which will soon change.
  • Beginning in 2014, LGBT Americans will have access to more affordable health insurance through new regulated state based insurance exchange marketplaces.
  • A non-discrimination policy will apply in the exchanges, which will ban discrimination by insurers based on sexual orientation and gender identity.
  • Public and private insurance plans are required to cover many preventive care services, many of which will benefit LGBT Americans.
  • The creation of federal programs to support community-based strategies to eliminate health disparities, like the Community Transformation Grants program.
  • The federal website,, will make it easier to locate insurers that cover same-sex domestic partners and help consumers to better understand the health reform law.
  • Federal investments in building a diverse and culturally competent workforce, which will be able to better serve members of the LGBT community.
  • Funding to support the expansion and bulding of new community health centers, which provide health care services to underserved populations, such as the LGBT community.
  • Creation of a nation-wide plan to reduce racial and ethnic health disparities. This includes plans to develop a long-term plan for addressing health disparities among LGBT individuals who are also racial minorities.


As the National Prevention Strategy under the ACA states, “all Americans should have the opportunity to live long, healthy, independent, and productive lives, regardless of their…sexual orientation or gender identity.” The ACA is already making a difference in the lives of many LGBT Americans, and many more benefits are still to come.

But a lot of work remains to be done in order to improve health care access and quality for LGBT Americans. CCHI is working with allies, such as One Colorado, to ensure that the LGBT voice is part of implementation of the ACA and future reforms that will help all Coloradans get the care they need, when they need it.

For a fact sheet on the Affordable Care Act and LGBT Coloradans click here.

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