Health Insurance Coverage and Access to Care by Sexual Orientation During the COVID-19 Pandemic: United States, January 2021-February 2022

To compare health insurance coverage and access to care by sex and sexual minority status during the COVID-19 pandemic and assess whether lack of insurance hindered access to care by sexual minority status. Using Behavioral Risk Factor Surveillance System data (January 2021-February 2022), we examin...

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Bibliographic Details
Published in:American journal of public health (1971) 2024-01, Vol.114 (1), p.118-128
Main Authors: Nguyen, Kevin H, Levengood, Timothy W, Allen, Heidi L, Gonzales, Gilbert
Format: Article
Language:English
Subjects:
Adult
Adults
COVID-19
COVID-19 - epidemiology
Female
Gender identity
Health care access
Health care industry
Health insurance
Health Services Accessibility
Heterosexuality
Humans
Insurance
Insurance Coverage
Insurance, Health
LGBTQ people
Male
Men
Mental health
Pandemics
Public health
Risk factors
Risk taking
Sex
Sex differences
Sexual and Gender Minorities
Sexual Behavior
Surveillance
Surveillance systems
Uninsured people
United States - epidemiology
Unwinding
Women
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Summary:To compare health insurance coverage and access to care by sex and sexual minority status during the COVID-19 pandemic and assess whether lack of insurance hindered access to care by sexual minority status. Using Behavioral Risk Factor Surveillance System data (January 2021-February 2022), we examined differences by sex and sexual orientation among 158 722 adults aged 18 to 64 years living in 34 states. Outcomes were health insurance coverage type and 3 access to care measures. Sexual minority women were significantly more likely to be uninsured than were heterosexual women, and lack of insurance widened the magnitude of disparity by sexual minority status in all measures of access. Compared with heterosexual men with health insurance, sexual minority men with health insurance were significantly more likely to report being unable to afford necessary care. During the pandemic, 1 in 8 sexual minority adults living in 34 study states were uninsured. Among sexual minority women, lack of insurance widened inequities in access to care. There were inequities among sexual minority men with health insurance. Sexual minority adults may be disproportionately affected by the unwinding of the COVID-19 public health emergency and may require tailored efforts to mitigate insurance coverage loss. ( 2024;114(1):118-128. https://doi.org/10.2105/AJPH.2023.307446).
ISSN:0090-0036
1541-0048
1541-0048
DOI:10.2105/AJPH.2023.307446