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LGBT Healthcare 411 Under the Evolving ACA

  October 16, 2018  |    #Live Fabulously

LGBT Healthcare Concerns are Real

There’s a lot of noise surrounding the Affordable Care Act, and that makes it hard to distinguish truth from partisan rhetoric. A recent Policygenius survey regarding the ACA reveals that literacy around the law—and health insurance in general—is distressingly low. Where can we go for accurate information as open enrollment approaches? How should LGBT healthcare concerns be taken into consideration?

Policygenius and LGBT healthcare

Myles Ma is the Managing Editor for Policygenius, an online magazine and marketplace on a mission to offer an easy way to compare and purchase insurance coverage of all kinds. Policygenius makes insurance shopping faster, friendlier and transparent, serving as a one-stop-shop for financial protection and educational content. Myles has been writing about personal finance, business development, and local, state and national policy since 2008, and he earned his degree in journalism from The College of New Jersey.

Today, Myles joins us to discuss the big picture impact of the ACA since it became law in 2010. He explains how the law has changed since Trump took office and the influence those changes have on insurance premiums. Myles discusses issues specific LGBT healthcare, including coverage for trans individuals and the lack of policies that cover PrEP. He offers insight on qualifying for subsidies, the high cost of insurance in the US and the potential benefits of a high-deductible health plan. L

Listen to learn about the state of the ACA & LGBT healthcare:

Healthcare's a huge and growing part of the economy. It's not sustainable for it to keep growing. It’s going to eat the whole economy. - Myles Ma of PolicygeniusClick To Tweet

Topics covered and the ACA and LGBT healthcare

What’s changed since the ACA became law

  • Millions more have insurance that didn’t before
  • Allows states to expand Medicaid to all low-income
  • Requires insurers to cover preexisting conditions

Changes to the ACA since Trump took office

  • Eliminate individual mandate (no tax penalty)
  • Increase in premiums with a threat to repeal

The individual mandate

  • Healthy, young people ‘pay it forward’
  • Pool money, subsidize those who need care

Myles’ advice about coverage for the trans community

  • Already difficult to secure coverage
  • Communicate with provider AND insurer
  • Ensure that policy includes specific needs

Myles’ insight on government subsidies

  • No changes on the horizon this year
  • Admin stopped cost-sharing reduction in 2017

How to calculate your income to qualify for subsidies

  • Use adjusted gross income ($ made minus deductions)
  • Numbers from most recent return + any adjustments

Why health insurance costs are so high in the US

  • Cost of healthcare very expensive in general
  • Not sustainable for healthcare to ‘eat the whole economy’
  • Don’t treat chronic conditions until catastrophe

High-deductible vs. traditional healthcare plans

  • Add premium + maximum out-of-pocket cost
  • Consider HDHP if lower number (even in worst-case)
  • HDHP gives the option to put $ in HSA

The benefits of holding on to an HSA

  • Tax-free to contribute money
  • Use for medical emergencies/expenses
  • Use for anything once reach retirement age

Why so few health plans cover PrEP

  • Insurance time slower than regular time
  • Challenge insurer if denied coverage

The results of the Policygenius ACA Survey

  • Awareness of basics distressingly low
  • 25% believe ACA was repealed
  • 21% know open enrollment period
  • 20% aware of essential health benefits

What the Policygenius site offers

  • Financial protection products
  • Marketplace + educational content

Connect with Myles

Resources for the ACA and LGBT healthcare

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