When the Supreme Court decision in the case of Obergefell vs. Hodges legalized same-sex marriage in 2015, it also expanded access to employer-sponsored insurance as a dependent for lesbian, gay, bisexual, and transgender (LGBT) adults.

In their new Health Affairs article, Andrew Bolibol and coauthors examine trends in health insurance coverage and access to care for LGBT and non-LGBT adults in the years after the implementation of the Affordable Care Act.

The authors find that, "although insurance coverage increased for all groups during our analysis period, the change was greatest for partnered LGBT people, and for this group, the gains were driven by an increase in private health insurance coverage," suggesting the importance of dependent coverage.

By the end of the study period in 2019, there was no statistically significant difference in overall insurance coverage rates for LGBT and non-LGBT adults; however, significant disparities in access did remain.

For more articles, podcasts, events, and more about health equity, visit our dedicated landing page.

Today in Health Affairs Forefront, Amol Navathe and colleagues describe ways to align payment design with equity in the areas of organizational participation, payment rules, and risk adjustment. Stay tuned for the second installment in this article series tomorrow.

Zach Baron and Andrew Twinamatsiko discuss current and future legal attacks against the Medicare Drug Price Negotiation Program.

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Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.

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