Kevin H. Nguyen (
Amal N. Trivedi is an associate professor in the Department of Health Services, Policy, and Practice, Brown University School of Public Health and a research investigator at the Providence Veterans Affairs (VA) Medical Center.
Health Aff (Millwood). 2018 Aug;37(8):1306-1312. doi: 10.1377/hlthaff.2018.0281.
The uninsurance rate among lesbian, gay, and bisexual (LGB) adults has dropped since the Affordable Care Act (ACA) and legalization of same-sex marriage. Less is known about whether disparities in access to care and health outcomes have narrowed in LGB adults compared to their straight peers in the post-ACA era. We used data from three waves of the Behavioral Risk Factor Surveillance System to examine access to a personal doctor, affordability of care, type of health insurance coverage, and self-reported health in LGB adults in the period January 2014-February 2017 in thirty-one states that implemented the system's sexual orientation module. Compared to straight adults, more LGB adults reported avoiding necessary care because of cost and worse self-reported health outcomes, even if they had health insurance. More LGB adults reported having individually purchased insurance, which suggests that the repeal of the ACA's individual mandate may create challenges in the affordability of necessary care.
同性恋、双性恋和无性恋（LGB）成年人的无保险率自《平价医疗法案》（ACA）和同性婚姻合法化以来有所下降。关于在 ACA 之后的时代，与异性恋同龄人相比，LGB 成年人在获得医疗服务和健康结果方面的差距是否缩小，了解较少。我们使用行为风险因素监测系统的三个波次的数据，在 2014 年 1 月至 2017 年 2 月期间，在实施该系统性取向模块的三十一个州，检查了 LGB 成年人获得私人医生、医疗保健负担能力、健康保险类型和自我报告健康状况的情况。与异性恋成年人相比，即使有医疗保险，更多的 LGB 成年人报告因费用而避免必要的医疗，并且自我报告的健康结果更差。更多的 LGB 成年人报告说他们单独购买了保险，这表明 ACA 个人授权的废除可能会给必要医疗的负担能力带来挑战。
