Out2Enroll, a national initiative pushing enrollment in the LGBT community, spent last week working with North Carolinians who are doing ACA sign-ups to make sure the message is spread in ways that include people who have often been shut out, said Katie Keith, an Out2Enroll leader who did training in Charlotte, Raleigh, Greensboro and Asheville.
Many may be wary because they've faced insurance discrimination in the past, said Keith, whose Trimpa Group progressive consulting firm has long been active in sexual orientation issues. The ACA, often dubbed Obamacare, explicitly bans discrimination based on sexual orientation or gender identity. It also specifies that people changing gender can't be denied coverage by defining it as a pre-existing condition, she said, though people still need to carefully check individual policies to see how such transgender issues as hormone therapy and counseling are covered.
"Folks don't think of health care as an equality issue, but in many ways it is," Keith said.
Out2Enroll was created by Trimpa, the Center for American Progress and the Sellers Dorsey Foundation. Its web site offers consumer guidance on such issues as whether same-sex couples can apply for family coverage on the ACA exchange (yes if they're legally married, no if they're in a different type of partnership). There's also a look-up to help LGBT people find enrollment help from groups that have gone through cultural competency training. So far none of the Charlotte groups has the rainbow logo that indicates that endorsement, but Keith says that's changing. She met with local enrollment workers and spoke to some LGBT-welcoming churches during the North Carolina tour.Research by the Center for American Progress, a Washington-based progressive advocacy group, shows the first year of the ACA has reduced the percentage of low- and moderate-income LGBT people who are uninsured. In 2013 the group found that just over one-third of people with incomes at or below 400 percent of the federal poverty level (the cutoff for getting federal subsidies) were uninsured. In 2014 that had dropped to 26 percent.