A Critique of Repealing the Affordable Care Act: Implications for Queer People of Color

Abstract

Public health has expanded health disparities research to include the importance of mental health. Minority stress theory provides a framework for contextualizing these disparities. Queer people of color (QPOC), who are studied far less often than other marginalized groups, face unique distal and proximal stressors as a consequence of their social location. Historically, the healthcare system has served as a conduit for these stressors, with bias and discrimination occurring at interpersonal and structural levels. The Patient Protection and Affordable Care Act (ACA) served to lessen the stressful impact of the healthcare system, specifically by improving access to mental health services for people of color and queer people. The authors utilize a minority stress framework to present information about the separate mental health access gains for people of color and LGBT people and hypothesize about how these gains affect QPOC. This study then uses these gains to frame a discussion about the positive impact of the ACA and discusses the disproportionate impact that repeal of such policy gains could have on the well-being of QPOC. Public health as a discipline has strong roots in social justice and has emerged as a preeminent space for the exploration of health disparities. Examining, and seeking to eliminate, health disparities is inherently an exercise in social justice (Braveman, 2014; Braveman et al., 2011). This effort is wide-ranging and often inter-and transdisciplinary. Public mental health has become a recent area of focus, recognizing the importance of one's mental health in overall well-being, as

Trends in Health Care Access/Experiences: Differential Gains across Sexuality and Sex Intersections before and after Marriage Equality

“…Although there has been substantial social progress with regard to sexual minority visibility and rights, our findings indicate the greatest gains in health care access and satisfaction were limited to gay men, with gay men also having the only significant increase in health care access trends post-marriage equality. Sexual minority groups other than gay men may face unique barriers to health care access, such as the intersectional barriers to health care faced by sexual minority women [29]. Bisexual men and women often face greater health care disparities compared to their gay counterparts; this is evident in bisexual men being the only group with decreasing health care access over time.…”

“…Importantly, national health agencies and medical professions have become more aware of the unique health needs of this population. The implementation of the Affordable Care Act and the legalization of national marriage equality also led to important gains in health insurance coverage for sexual minority adults [29]. Thus, one would infer that sexual minority adults may have experienced substantial gains in health care access and reduced experiences of stigma when seeking health care.…”