LGBTQ adults still struggle to afford health care

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PROVIDENCE, R.I. — A study from Brown University reported this week that although LGBTQ adults are insured at the same rate as heterosexuals, they still avoid medical treatment because of cost.


“I started looking at this question because I had read a few studies indicating that following the ACA’s implementation in 2014 and the legalization of same-sex marriage in 2015, there were comparable rates of uninsurance for LGB adults,” said Kevin Nguyen, lead author of the Aug. 6 study in the August issue of Health Affairs. “However, insurance is only one step in receiving care—I was curious to see if there were other differences in the access to care and health outcomes.”

Nguyen is a doctoral student at the Brown University School of Public Health. Dr. Amal N. Trivedi, an associate professor of health services, policy and practice, and an associate professor of medicine at Brown, and Theresa I. Shireman, a professor of health services, policy and practice at Brown, were co-authors on the study.

The researchers analyzed three publically available data sets from the CDC spanning from 2014-15—the first year the survey asked about sexual orientation—to 2016-17, the most current data set. The study included about 330,000 adults between ages 18 and 64, 4.3 percent of whom identified as lesbian, gay or bisexual.

Of those surveyed via the study, 16.4 percent of LGB adults reported avoiding or delaying medical treatment for financial reasons, compared to 14.2 percent of their straight peers. Given the large number of people surveyed, that difference proved statistically significant, the researchers said.

Though the study did not explore the cause of the difference in being able to afford , Nguyen said, based on prior studies, one possible explanation is that more LGB adults had individually purchased insurance, which may have higher copays or deductibles than employer-sponsored insurance. Another possibility is that on average LGB individuals may need more medical services than straight individuals.

In addition to similar levels of , the study also found that LGB individuals now report comparable levels of having a primary care doctor and having an annual check-up as their straight peers—approximately 77 percent and 66 percent, respectively.

Yet despite comparable levels of access to health care, LGB adults reported 5.3 days in the last month where poor health prevented them from doing normal activities, compared to 4.9 for their straight peers. Similarly, they reported 5.6 poor mental health days (days with stress, depression or emotional problems) in the last month, compared to 3.9.