LGBTQ+ adults in the US are more likely to miss appointments, delay treatment or skip prescriptions because of cost and access barriers, according to a new KFF survey. The findings matter because these missed moments can have lasting consequences, particularly for transgender people, younger adults, uninsured households and those on lower incomes.

Essential Takeaways

  • Care is being missed: Six in 10 LGBTQ+ adults surveyed said they’d gone without needed healthcare in the past year, compared with 38% of non-LGBTQ+ adults.
  • Cost is a major barrier: One in five LGBTQ+ respondents skipped prescriptions because they couldn’t afford them.
  • Health can deteriorate: Three in 10 said their health worsened after delaying or missing care.
  • Trans adults face sharper obstacles: Nearly half reported that their health had worsened after care was postponed.
  • Insurance doesn’t guarantee access: Denials were more common among insured LGBTQ+ adults, especially those using Medicaid or self-purchased plans.

The gap is bigger than a missed appointment

A missed check-up can sound minor, but the survey paints a more serious picture. According to KFF, 60% of LGBTQ+ adults surveyed had missed needed care during the previous year, compared with 38% of non-LGBTQ+ adults. Cost, unavailable appointments and other practical barriers all played a part. [2], [3]

The consequences were tangible rather than merely administrative. Around three in 10 LGBTQ+ respondents said their health worsened after delaying or forgoing care, almost twice the proportion reported by other adults. It’s the sort of avoidable setback that can turn a manageable concern into a much harder one. [4], [6]

Prescription costs are forcing difficult choices

Medication is another pressure point. KFF found that 22% of LGBTQ+ adults had gone without prescribed medicines because of the price, compared with 12% of non-LGBTQ+ adults. Nearly 30% also said they’d struggled to pay medical bills, while the comparable figure for non-LGBTQ+ adults was about one in five. [2], [5]

Those figures help explain why access isn’t simply about whether someone has insurance. A person may technically be covered and still face unaffordable co-payments, gaps in pharmacy benefits or bills that arrive long after treatment. For patients managing ongoing medication, even a short interruption can feel risky and unsettling. [3], [7]

Transgender adults report the steepest impact

Transgender respondents experienced some of the starkest difficulties in the survey. Nearly half said their health had become worse after they missed or delayed care, while denials and delays involving treatment, prescriptions or services were also more pronounced. [2], [4]

The wider results show variation within the LGBTQ+ population, too. LGBTQ+ women reported worsening health more often than men, at 63% compared with 46%, according to the survey summary. That difference suggests that gender, income, insurance status and the type of care someone needs can overlap in complicated ways. [5], [6]

Younger and uninsured adults are especially exposed

People under 30 were particularly likely to forgo care. LGBTQ+ adults in that age group were 20 percentage points more likely to report skipping needed healthcare than non-LGBTQ+ adults of the same age, while uninsured LGBTQ+ respondents were among the most likely to miss treatment. [2], [3]

The survey also points to broader economic conditions. LGBTQ+ people are, on average, younger than the US population and more likely to have lower incomes or lack coverage. The researchers cautioned that these factors may help explain the gap, although they’re closely tied to the lived experience of LGBTQ+ identity and healthcare access. [4], [7]

Insurance denials show coverage isn’t the whole answer

Even among insured respondents, 32% of LGBTQ+ adults reported an insurance denial, compared with just over one in five non-LGBTQ+ adults. Denials were especially noticeable among people covered through Medicaid or individual insurance plans. [2], [5]

That makes the practical lesson fairly clear: checking whether a plan is accepted by a provider isn’t enough. Patients may also need to confirm prior authorisation rules, prescription coverage and appeal procedures before treatment begins. It’s tedious paperwork, but knowing those details early can prevent an unpleasant surprise later. [6], [7]

The report’s findings are likely to keep attention on affordability, provider availability and insurance administration, rather than treating missed care as a matter of personal choice. Nobody should have to decide between a prescription and the rest of the month’s essentials. [3], [4]

Small barriers can create serious health consequences when they keep piling up. [2], [5]

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