The Affordable Care Act and Health Insurance Coverage for Lesbian, Gay, and Bisexual Adults: Analysis of the Behavioral Risk Factor Surveillance System

Purpose: This study compares uninsurance rates for lesbian, gay, and bisexual (LGB) adults by state Medicaid expansion decisions under the Affordable Care Act. Methods: Data come from nonelderly adults in the 2014 Behavioral Risk Factor Surveillance System. Prevalence estimates and logistic regression models identified LGB adults most likely to be uninsured. Results: Approximately 15.7% of LGB adults lack health insurance, but the uninsurance rate is lower among LGB adults in Medicaid expansion states (12.5%) compared with LGB adults in nonexpansion states (20.0%). Conclusions: Expanding Medicaid in states that have not yet done so should increase coverage and lead to improved health for vulnerable LGB adults.