Key Lessons for LGBT Outreach and Enrollment

INITIAL OPEN ENROLLMENT PERIOD OFFERED SIGNIFICANT OPPORTUNITIES TO PROMOTE LGBT OUTREACH AND ENROLLMENT, BUT MORE MUST BE DONE

New Report Highlights Need for Federal and State Officials to Ensure LGBT-Specific Outreach, Training, and Data Collection in Every State

Report CoverWashington, DC, July 24, 2014—The initial open enrollment period offered significant opportunities to reach lesbian, gay, bisexual, and transgender (LGBT) consumers, but the visibility and effectiveness of these efforts varied significantly by state. According to a new report from Out2Enroll, a nationwide campaign dedicated to connecting LGBT people with their coverage options, variation largely resulted from the level of formal marketplace commitment to LGBT inclusion and the extent to which LGBT community and allied organizations were able to participate in the health reform effort.

The report, Key Lessons for LGBT Outreach and Enrollment Under the Affordable Care Act, was released in conjunction with a White House briefing on July 24, 2014. The report found that effective efforts to reach LGBT communities included:

  • Development of LGBT-specific messaging and education materials;
  • Targeted efforts to engage LGBT people via outreach and enrollment events; and
  • A consistent presence at LGBT community venues.

Some state-based marketplaces, for example, clearly identified LGBT communities as an underserved population, engaged LGBT organizations in conducting outreach and enrollment, and included LGBT families in marketplace advertisements. In states with a federal marketplace, some state assister coalitions directly included LGBT organizations, and others made specific efforts to engage trusted LGBT organizations to promote outreach and enrollment.

“Given the significant health disparities that affect the LGBT population—and the fact that one in three low- and middle-income LGBT people were uninsured in 2013—efforts to engage LGBT communities are critical,” said Out2Enroll Steering Committee Member Kellan Baker. “We are encouraged to see the creative and innovative ways that stakeholders across the country are working to reach LGBT people.”

The report also concludes that LGBT outreach was complicated in many states by uncertainty surrounding outstanding policy issues. Specifically, stakeholders in a variety of states reported significant confusion about:

  • Relationship recognition, including the treatment of legally married same-sex spouses, domestic partners, and people in civil unions;
  • Transgender health needs, including the continued prevalence of transgender-specific insurance exclusions;
  • Discriminatory practices, including insurance carrier practices that discourage enrollment of those with chronic conditions such as HIV; and
  • Plan transparency, including the lack of accessible information providing adequate details on coverage limitations.

According to the report, federal and state officials have taken steps to address some—but not all—of these issues. “LGBT consumers continue to raise concerns about issues such as discriminatory coverage practices and the need to understand the plans they are purchasing through the marketplace,” said Out2Enroll Steering Committee Member Katie Keith. “Resolving these issues should be a priority for state and federal officials to help ensure that the Affordable Care Act meets the needs of LGBT communities.”

Moving Forward

Although the initial open enrollment period offered significant opportunities to raise awareness and promote LGBT health equity, the report notes that more must be done to ensure that LGBT people are able to fully understand and take advantage of their new coverage options under the Affordable Care Act.

The report includes the following recommendations to promote LGBT outreach and enrollment during the next open enrollment period, beginning in November 2014:

  • Outreach and enrollment efforts in every state should explicitly include LGBT communities.
  • Assisters, including navigators and certified application counselors, should receive LGBT-specific cultural competency training.
  • All marketplaces should collect voluntary demographic information on sexual orientation and gender identity.

“LGBT people are—and will continue to be—part of the success story of health reform,” said Out2Enroll Steering Committee Member Chris Labonte. “Out2Enroll will build on the successes of 2014 and continue to connect LGBT people in every state with the information and resources they need.”

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