As end-of-year health care deadline draws near, LGBT outreach intensifies

December 16, 2013

(Mathew Sumner/AP)

The lesbian, gay, bisexual and transgender community is not only one of President Obama’s staunchest supporters. It is a key target for the Affordable Care Act, which is why this group has become increasingly important as the end of the year approaches.

A disproportionate number of LGBT Americans are uninsured and qualify for federal premium subsidies, which is one reason both outside groups and the administration are intensifying their efforts this week to sign them up under the law. There are several reasons for this disparty, including the fact that same-sex partners often don't qualify as family members for employer-based insurance plans and individuals sometimes lose coverage when they are fired based on their sexual orientation.

On Tuesday the White House will release an infographic on the Affordable Care Act’s benefits for the LGBT community, according to a White House official who asked not to be identified because the feature had not been launched yet.

Out2Enroll, a collaboration between the Sellers Dorsey Foundation, the liberal think tank Center for American Progress and the Federal Agencies Project, is working to educate men and women in major cities about their options for coverage under the health law and how to navigate the system. According to CAP, 34 percent of LGBT Americans are eligible for federal assistance because they have incomes of up to 400 percent of the federal poverty level.

The group already has held workshops in major cities such as Houston, New York and Philadelphia. On Thursday, for example, White House public engagement adviser Gautam Raghavan joined Health and Human Services Region III director Joanne Grossi in holding a training session with navigators in Philadelphia, as well as a town hall event, both focused on LGBT community members.

Some of the pitches are decidedly less conventional. Wednesday Night Tea, a drag show in Shreveport, La., has started promoting the health care law as part of its act. And Out2Enroll is launching a social media campaign this week that will have “naughty” elements as well as holiday cheer, according to Kellan Baker, associate director of the LGBT Research and Communications Project at CAP.

The push is likely to resonate with many LGBT Americans, especially those not working in conventional jobs. Sixty-three-year old Kenny Weinberg has struggled to get adequate coverage for himself and his 60-year-old husband, Jeffrey, since he lost his job in the fashion industry in 2008.

The couple moved from New York City to Philadelphia to cut costs, but that meant they were no longer eligible for the plan they had because it only applied to New York residents. As retirees, they had trouble finding a reasonable private plan due to a preexisting condition of Jeffrey’s. In the past year, Weinberg said, “our out-of-pocket expenses have totaled close to $20,000.”

While Weinberg couldn’t initially access HealthCare.gov, he managed to sign up for an HMO plan earlier this month.

“It will truly make a tangible difference in our lives,” said Weinberg, who attended the Out2Enroll community session in Philadelphia last week. “We started avoiding going to doctors. It’s an opportunity to get back into better health.”

Ezra, a 35-year-old fundraising consultant who asked to be referred to only by his first name, has been uninsured for three years. A self-described “white transmasculine gender queer,” he had been getting primary care and hormone therapy at Philadelphia’s Mazzoni Center.

After initial problems with HealthCare.gov—“It calculated my income at $96,000, and I was like, ‘I don’t think so,’” Ezra recalled. He found a  health plan for $70 a month and dental insurance for $18 a month.

Ezra still faces some challenges: The Mazzoni Center is a Tier 3 provider under his new plan, meaning that his co-pays will double there compared to when he's uninsured. So while he is now covered if he faces a catastrophe, his hormone therapy will be more costly. He said that while he initially thought, "Oh yay, it was so easy," then he discovered, "Nope, it’s not."

And he added that plenty of his friends — especially those who are undocumented immigrants, and therefore ineligible under the law — are still uninsured.

“I’m glad this worked for me, but I think it’s far from meaning the system has worked out for queer/trans people,” he said.

Baker noted that many gays, lesbians and transgender Americans have had “pretty bad experiences with the health care system,” and some are unsure of how they might qualify, given their same-sex relationships. But he estimated that 900,000 members of the community could get some form of subsidized health care under the law.

Out2Enroll is hoping to enroll 300,000 people under the law. Baker noted that since no one is formally tracking the sexual orientation of those signing up for insurance, their measure of success may be hard to assess.

“Who knows whether we’ll be able to get that close, or even whether we’ll be able to know if we’ve done that,” he said. “There are a lot of cases where we won’t know.”

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Aaron Blake | December 16, 2013