The last week of March has been LGBT Health Awareness Week since 2003. We have gone over some of the barriers to health care for some of the transgender community in previous blog posts, but it remains important to bring awareness to the unique healthcare needs of lesbian, gay, bisexual, and transgender people and the health disparities that continue to beleaguer the lives of so many Americans.

Experts report that LGBT people often avoid seeking out medical care or refrain from “coming out” to their healthcare provider. This compromises an entire community of lesbian, gay, bisexual, and transgender individuals who are at increased risk for several health threats when compared to heterosexual or cisgender peer groups: Gay men are at higher risk of HIV and other sexually transmitted infections; lesbians are less likely to get cancer screenings; transgender individuals are among the least likely to have health insurance along with risks from hormone replacement and atypical cancers. Even as youths, LGBT people are at higher risk of violence, depression, substance abuse, homelessness, and other suicide-related behaviors.

The Affordable

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Open enrollment for Affordable Care Act (ACA; aka Obamacare) coverage ended across the United States in mid-December, but the last few states ended their open enrollment period at the end of January. We wrote in November about the state of Open Enrollment, and discussed the impacts of confusion surrounding the healthcare law earlier this year. Now that the open enrollment period has ended, we’re able to look at the numbers of people who took advantage and those still left underserved.

Even with enrollment period cut in half and other changes enacted by the Trump administration, nearly 11.8 million people signed up for healthcare on healthcare.gov or through their state’s marketplace. Experts say that had Open Enrollment period not been so much shorter and outreach funding not been cut 90%, an additional 1.1 million Americans would have enrolled. Returning ACA enrollees marginally increased since last year, however new enrollment fell 29% with the Trump administration’s cuts. Of the ten states that extended their enrollment periods beyond the shortened 45-day period, seven of them surpassed the enrollment from the previous year.

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Medicaid is the United States’ public health insurance program for people with low incomes and chronic health conditions. Medicaid covers one in five Americans; mostly children, people with disabilities, and the elderly. The Affordable Care Act (ACA; aka Obamacare) expanded Medicaid coverage to include the working poor (those who make 138% of the Federal Poverty Level or below) who do not typically have access to affordable care. Thirty-two states have implemented the ACA’s Medicaid expansion. Some states, along with the Trump administration, have pushed for imposing a work requirement for Medicaid recipients.

Of the 25 million affected by the Medicaid expansion nearly 80% live in working families, many of whom are self-employed. Close to half of working Medicaid enrollees work for small businesses which often do not offer health coverage. Most of those who are not working report inability to work due to illness, disability, or caregiving responsibilities.

Kentucky

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Health care in America was a constant subject of conversations in public venues and political forums in 2017. There has been confusion about health insurance, failed legislation, Executive Orders reversing Obamacare guidelines, tax plans affecting healthcare costs, and the failure to fund healthcare programs that cover millions of low-income Americans. People in the United States continue to count healthcare costs as a major concern.

We at NeedyMeds prefer to remain apolitical, but it is difficult to avoid the partisan nature of the changes in health care in America since the Trump administration’s inauguration last year. Donald Trump ran on the platform of repealing the Affordable Care Act (aka ACA; Obamacare), saying it would be “so easy.” He claimed his Obamacare replacement would have “insurance for everybody” and that “Everybody’s going to be taken care of much better than they’re taken care of now.” In practice, all “Trumpcare” bills failed to pass through Congress due

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This year we have been tracking the evolution of healthcare in the United States under the Trump administration, from the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA) bills failing to pass through Congress, the expiration of the Children’s Health Insurance Plan (CHIP) which covers 9 million children—many of whom have chronic health conditions—to Executive Orders undermining the Affordable Care Act (ACA; aka Obamacare) to the effect of destabalizing the insurance markets, causing confusion among consumers and higher premiums and out-of-pocket costs. More recently the U.S. Congress has been focused on tax reform, though critics have described efforts as a healthcare repeal disguised as a tax bill. This week the nonpartisan Congressional Budget Office (CBO) has scored the Senate’s Tax Cuts and Jobs Act bill that, if passed, could take effect on January 1, 2018.

For those concerned with America’s growing debt, the CBO analysis finds the $1.4 trillion would be added to the federal deficit over the next decade. Critics decry raising taxes for lower-income families while lowering

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