Health insurance coverage and access to care continue to decline for sexual minorities during COVID-19, study finds

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In the United States, uninsured rates among sexual minorities have steadily increased from lows in 2016, affecting populations that have historically had less access to comprehensive health care than heterosexual individuals.

A new study led by researchers at the Boston University School of Public Health (BUSPH) shows that inequities in health insurance coverage and access to care have widened further during the COVID-19 pandemic.

Published on American Journal of Public HealthStudies have found that sexual minority women are more likely to be uninsured than heterosexual women, while sexual minority men face greater challenges than heterosexual men in providing necessary health insurance care.

The new study builds on previous research on these differences but assessed a much larger study population than past studies, including nearly 160,000 U.S. adults.

These findings suggest that insurance status is an important driver of access to care for sexual minorities, who may be disproportionately affected as state-level eligibility rules continue to change nationwide following the expiration of Medicaid continuity coverage protections earlier this year to lose health insurance. Year. Medicaid covers a higher proportion of sexual minority adults than heterosexual adults.

“The steady increase in uninsurance rates starting in 2017 may reflect efforts to undermine the Affordable Care Act during President Donald Trump’s administration,” said study leader and corresponding author Kevin Nguyen, Ph.D., assistant professor of health law, policy and management. “Our research shows that sexual minority adults may be disproportionately affected by job losses and health insurance losses during the pandemic.”

In this study, Dr. Nguyen and colleagues from BUSPH, Columbia University School of Social Work, and Vanderbilt University used Behavioral Risk Factor Surveillance System data to examine differences in health insurance coverage types and access to care by gender and sexual orientation . Between January 2021 and February 2022, there were 158,722 adults aged 18-64.

Overall, about 1 in 8 nonelderly sexual minority adults across 34 states were uninsured in 2021, compared with 1 in 10 heterosexual adults. Sexual minority men and women are more likely than heterosexual adults to have no employer-sponsored health insurance and are more likely than heterosexual men and women to have Medicaid coverage.

Sexual minority women, especially those who are uninsured, are less likely to have had a private doctor or check-up in the past two years. While sexual minority men are more likely to have health insurance and a doctor, they have more difficulty paying for medical care than their heterosexual peers.

The researchers highlight that public policy may play a key role in reducing health inequalities. They found that, for both men and women, living in states with the most inclusive LGBTQ+ policies reduced the gap in affording necessary medical care compared to states with negative LGBTQ+ policies.

Expanding Medicaid coverage in the ten states that have not yet done so could also reduce disparities in uninsured low-income sexual minority adults, the research team said. Wider policy changes to support wellbeing can also help close gaps in access to care.

“Because inequalities in health insurance coverage and access to care partly reflect discrimination and structural barriers, social policies that provide for equality through sexual orientation and/or gender identity, such as the passage of the federal Equality Act, There may be positive impacts on health, financial security and access to care,” said Dr. Nguyen.

More information:
Kevin H. Nguyen et al., Health Insurance Coverage and Sexual Orientation Access to Care During the COVID-19 Pandemic: United States, January 2021-February 2022, American Journal of Public Health (2023). DOI: 10.2105/AJPH.2023.307446

Provided by Boston University

citation: Health insurance coverage and access to care for sexual minorities continue to decline during coronavirus pandemic, study finds (2023, December 14) Retrieved December 14, 2023 https://medicalxpress.com/ news/2023-12-health-coverage-access-decline -sex.html

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