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Health insurance coverage, access to care continued to decline for sexual minorities during COVID – study

Sexual minority women were significantly more likely to be uninsured than heterosexual women, and sexual minority men faced greater challenges affording necessary care with health insurance than heterosexual men.

Photo by Yeo Yonghwan from Unsplash.com

Uninsurance rates among sexual minorities have increased steadily, thereby affecting a population that has historically had fewer opportunities to access comprehensive health services, compared to heterosexual individuals. And these inequities in health insurance coverage and access to care widened even further during the COVID-19 pandemic.

This is according to a study led by a Boston University School of Public Health (BUSPH) researcher. Published in the American Journal of Public Health, the study – “Health Insurance Coverage and Access to Care by Sexual Orientation During the COVID-19 Pandemic: United States, January 2021–February 2022” by Kevin H. Nguyen, Timothy W. Levengood, Heidi L. Allen PhD, and Gilbert Gonzales PhD – found that sexual minority women were significantly more likely to be uninsured than heterosexual women, and sexual minority men faced greater challenges affording necessary care with health insurance than heterosexual men.

The study builds upon previous research about these disparities, but assesses a much larger study population than past studies—nearly 160,000 US adults.

According to study lead and corresponding author Dr. Kevin Nguyen: “Our study suggests that sexual minority adults may have been disproportionately impacted by employment loss and health insurance loss during the pandemic.”

For the study, Dr. Nguyen and colleagues from BUSPH, Columbia University School of Social Work, and Vanderbilt University utilized data from the Behavioral Risk Factor Surveillance System data to examine differences in health insurance coverage type and access to care by sex and sexual orientation among 158,722 adults ages 18-64, from January 2021 to February 2022.

Overall, about 1 in 8 nonelderly sexual minority adults in 34 American states were uninsured in 2021, compared to 1 in 10 heterosexual adults. Sexual minority men and women were much more likely to not have employer-sponsored health insurance compared to heterosexual adults, and were more likely to have Medicaid insurance than heterosexual men and women.

The researchers emphasize that public policies likely play a critical role in reducing health inequities. They found that, for both men and women, living in American states with the most inclusive LGBTQ+ policies narrowed the disparities in inability to afford necessary medical care compared to states with negative LGBTQ+ policies.

“Because inequities in health insurance coverage and access to care are, in part, a reflection of discrimination and structural barriers, social policies that codify equality by sexual orientation and/or gender identity could potentially have positive impacts on health, financial security, and access to care,” Dr. Nguyen ended.

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