EDUCATION & ACTION DURING COVID-19 SERIES

Ensuring LGBTQ Healthcare Protections

The public health threat of COVID-19 has shown us now, more than ever, the importance of mutual aid and community care. As part of our commitment to speed equality and opportunity for all, MAP will be publishing a series of Medium blog posts that advance the conversation around vulnerable communities who may be particularly at risk to the effects of the virus and the economic downturn. In the middle of an unprecedented global pandemic that affects us all, this series will shed light on the particular challenges facing all of our communities, as well as resources from partners and allied organizations to support you through the pandemic.

Given what we know about why LGBTQ people may be at higher risk for serious complications from COVID-19, it is deeply concerning that the Trump Administration is pushing forward with its plan to strip gender identity and sexual orientation healthcare protections.

The Affordable Care Act prohibits discrimination in health care based on sex, including by healthcare providers, insurance companies, and hospitals. Obama Administration regulations and a number of courts have already ruled that discrimination based on sexual orientation and gender identity is a form of sex discrimination, meaning LGBTQ people are also protected from discrimination in health care.

Yet now, the Trump Administration is moving forward with a final rule that would undo existing federal regulations prohibiting discrimination based on gender identity in health care. What’s more, through court decisions, the Trump Administration — as well as state legislatures, healthcare providers, and social service providers — are increasingly able to claim a religious or moral reason to refuse to care for people with whom they disagree. This means that LGBTQ people, women, people of minority faiths, and others can find themselves unable to access vital services like food assistance, health care, and emergency housing.

Let’s look at a recent example. Samaritan’s Purse, a Christian evangelical nonprofit organization operating a tent hospital for COVID-19 patients in New York City’s Central Park, requires that medical staff and volunteers sign a “Statement of Faith” that includes anti-LGBTQ language condemning marriage equality. By requiring COVID-19 responders to sign the statement, the organization is limiting its ability to serve patients effectively — not based on medical standards or patient needs, but rather based on religious beliefs that have nothing to do with medical treatment of a patient.

As attorney Jeffrey Toobin points out in the New Yorker, “‘Religious freedom’ is an Administration-wide initiative, and there’s no doubt about the primary target: the LGBTQ community.” This is especially concerning given that LGBTQ people have lower rates of insurance; they are more likely to delay medical care; and they report high levels of discrimination by healthcare providers:

  • A nationally representative survey by the Center for American Progress found that 8% of lesbian, gay, and bisexual adults and 29% of transgender adults said they had been turned away from a health care provider because of their sexual orientation or gender identity.
  • LGBTQ people who experienced any form of discrimination were nearly seven times more likely to report avoiding a visit to the doctor’s office to avoid discrimination.
Source: MAP, Religious Refusals in Health Care: A Prescription for Disaster, 2018

Particularly for LGBTQ people living in rural communities,¹ where health care facilities may be a distance away, allowing discrimination could leave them with no options for necessary health care. Millions of people, including LGBTQ people, live 30 minutes away or further from an ER that could treat coronavirus. Rural areas are also more likely to be served by religious healthcare providers, who may claim a right under religious exemptions laws to deny care for LGBTQ people and other vulnerable groups.

These experiences have a cumulative effect: research finds that LGBTQ people have lower overall health as a result of these barriers. Especially during a pandemic, no one should be denied medical care because of who they are or whom they love.

If you need healthcare assistance, here are some helpful resources:

Take Action

¹ Rural America is especially vulnerable to the spread of COVID-19, as rural communities are disproportionately older, disabled, and chronically ill.

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MAP is an independent, nonprofit think tank that provides rigorous research, insight and communications that help speed equality and opportunity for all.

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