Assessing Insurance Coverage Trends in Lesbian, Gay, and Bisexual Adults in the Post-ACA Era
LGB adults still delay medical care due to cost despite having access to insurance coverage.
Lesbian, gay, and bisexual (LGB) adults in the United States are likely to delay necessary medical care due to cost regardless of insurance status, according to research presented at the American Public Health Association 2018 Annual Meeting and Expo, held November 10-14 in San Diego, California.
Researchers from the Brown University School of Public Health in Providence, Rhode Island, examined insurance coverage in this patient population in the post-Affordable Care Act (ACA) era (2014 to 2017) compared with non-LGB peers.
The researchers gathered 3 years of data from the Behavioral Risk Factor Surveillance System, which was used to assess the relationship between self-reported LGB status and health insurance status, access to a physician, whether or not they had a physical in the past year, and any delays of necessary medical care due to cost. Models were adjusted for age, gender, income, education, and self-reported health status, among other criteria.
The unweighted survey sample included 271,249 adults age 18 to 64, with a household income of less than $75,000; 4.7% of this sample identified as LGB. When compared with heterosexual adults, LGB adults had similar adjusted rates of uninsurance (17.1% vs 17.7% for LGB and non-LGB results, respectively), access to a personal physician (72.2% vs 72.8%), and physical examination within the past year (63.1% vs 64.5%).
However, LGB adults were found to be more likely to delay accessing necessary medical care due to cost (22% vs 18.8% for LGB and non-LGB adults, respectively). This data remained static when researchers limited the sample to only those adults with an individually purchased health insurance plan (16.9% vs 13.9%).
“Prior studies indicate that disparities in uninsurance between lesbian, gay, and bisexual and straight Americans have narrowed since the implementation of the ACA and legalization of same-sex marriage,” said researcher Kevin Nguyen, a doctoral student in the Department of Health Services, Policy, and Practice at Brown University. “Whether these trends have been accompanied by narrowed disparities in access to care in the post-ACA era…was less of a focus in research.”
“This research…may inform future decisions by policymakers,” he added. “It will be important to continue to examine this topic with later data.”
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Nguyen K, Trivedi A, Shireman TI. Insurance coverage and access to care among lesbian, gay, and bisexual nonelderly Americans, 2014-2017. Presented at: American Public Health Association 2018 Annual Meeting and Expo; November 10-14, 2018; San Diego, CA. Abstract 4434.0