A host of federal protections — including rules prohibiting healthcare providers and insurers from limiting coverage or care based on sexual orientation and gender identity — may well hinge on the election this fall.
This is a dangerous and slippery slope. Access to essential healthcare for all LGBTQ+ people is not a political or cultural issue that’s open to debate. It is not a DEI initiative or a “woke” issue. It is, first and foremost, an equity issue — one that deserves broad support not only from the LGBTQ+ community and our allies but also from the employers and health insurers that provide healthcare to two-thirds of the U.S. population.
Health equity should be clear common ground. Whatever our individual political leanings, all of us — as individuals, taxpayers, employees, and employers — have a vested interest in addressing LGBTQ+ health disparities, which include disproportionately high rates of depression and anxiety, substance abuse disorders, cancer, and chronic medical conditions like diabetes.
All of these life-altering health problems are costly; many are preventable and avoidable if people get the right care at the right time. But far too many LGBTQ+ people are not getting the care they need.
Headline-grabbing issues like gender-affirming care and IVF are just the tip of the iceberg. LGBTQ+ people frequently encounter barriers to healthcare of all kinds, including routine primary and preventive care, mental health care, and specialty care.
As a gay man, I’ve experienced many of these barriers firsthand. I’ve struggled to find providers I feel comfortable with, who didn’t shame me, discriminate against me, or deny me services — and I know many others in the community have experienced far worse.
Even when outright discrimination or refusal of care isn’t at play, navigating health insurance and the healthcare system in general is more complex and challenging for the LGBTQ+ community.
A recent nationwide survey of insured U.S. workers conducted by Included Health and YouGov found that LGBTQ+ people were more likely to experience difficulty understanding their health benefits, healthcare costs, and billing. Notably, LGBTQ+ respondents were more likely than the workforce overall to say they had delayed or skipped care due to admin headaches or insurance challenges.
What happens when people delay or skip care? Cancer screenings are missed. Chronic conditions and mental health issues go unmanaged (and often feed on each other). People are more likely to end up in the emergency room or hospital.
No one wants these outcomes. LGBTQ+ people want to stay healthy and out of the hospital, and the employers and health insurers who are footing the bill want the same thing.
The good news is we know how to address these disparities and close these gaps in care. As the co-founder of an LGBTQ+ healthcare organization that now covers six million people, I’ve seen time and again that ensuring equitable access to high-quality care creates more confidence in the healthcare system, less care avoidance, and better health outcomes for LGBTQ+ people. We know what works.
First, employers and health insurers need to do their part. Organizations that are committed to health equity should focus on a few essentials:
Data. Identifying health disparities is the first step in addressing them. Build an accurate picture of the healthcare needs of your LGBTQ+ population by tapping into self-reported data on sexual identity and gender orientation, surveys, healthcare claims, and more. Aside from identifying disparities, these health equity assessments will enable you to design benefits and initiatives tailored to the LGBTQ+ community — and to measure their impact over time.
Diverse provider networks. Finding healthcare providers with LGBTQ+ expertise is a constant challenge. (Just 24% of the LGBTQ+ workers we surveyed were confident they could find a provider who understands LGBTQ+ health issues.) Yet we know culturally competent care drives better patient engagement and outcomes. Diversifying provider networks — including through virtual care — increases the odds that LGBTQ+ people can easily find primary care physicians, specialists, and mental health professionals that meet their needs.
Wrap-around support. Extra support with the many non-clinical aspects of care — including care coordination, navigation services, claims advocacy, and more — is helpful for anyone, but especially so for the LGBTQ+ community. As with healthcare providers, it’s a plus if case managers, care coordinators, and other non-clinical care team members have expertise with LGBTQ+ health.
LGBTQ+ individuals and our allies — including the parents and guardians of LGBTQ+ youth — also need to play a part in advocating for these resources and support. Actionable steps you can take today include:
Sharing your sexual orientation and gender identity with your employer and health insurance plan when asked in surveys and paperwork. This data is vital not only for representation but also for surfacing disparities and gaps in care. Feel empowered to let them know who you are.
Research your health benefits. Are you able to find providers in your network with LGBTQ+ expertise? What does your current plan cover for primary and preventive care, mental health, and LGBTQ+ health? You may have benefits you’re not aware of — and if you don’t have essential benefits, raise that with your employer’s HR team and/or health insurance company..
Join an LGBTQ+ employee resource group (ERG) at work — or start one if it doesn’t already exist. These groups are an important source of peer support, as well as advocacy and organizing. Check out Out & Equal for tips and recommendations on how to get an ERG off the ground.
If you have an internal DEI person or team, engage with them to ensure the LGBTQ+ voice is heard within your organization.
The politicization of LGBTQ+ health is frightening and discouraging, but we shouldn’t lose sight of the things we can control and act on today.
If the LGBTQ+ community, employers, and insurers rally around healthy equity, there is so much we can accomplish together that will have an immediate impact on the lives of millions of LGBTQ+ individuals and our workplaces and communities as a whole.
Colin Quinn is Included Health’s president of Communities. As a member of the LGBTQ+ community, he understands firsthand the challenges members of the LGBTQ+ community face navigating their healthcare. He is passionate about raising care equality for underserved patient populations. He also co-founded Included Health, which was acquired by Grand Rounds Health and Doctor on Demand and rebranded under the same name.
