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As ACA tax credits hang in the balance, disabled LGBTQ2S+ Americans struggle

While the U.S. government continues to debate healthcare subsidies, disabled people are scrambling to survive


Written By Rohan Zhou-Lee
February 13, 2026 last updated February 17, 2026

As ACA tax credits hang in the balance, disabled LGBTQ2S+ Americans struggle cover image
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On Jan. 8 in the United States, Lauren Underwood, Democratic Party congressperson of Illinois, reintroduced and passed through the Congressional House Chamber a bill that will extend healthcare subsidies provided by the Affordable Care Act (ACA) for three more years. The subsidies, which were introduced during the pandemic, greatly reduce cost of medicine, premiums and life-saving care, especially for people on disability benefits who are enrolled in Medicaid.

 All healthcare subsidies expired on Jan. 1, but this new bill—if ratified—will make them valid again. In the meantime, many are paying the market rate for their healthcare. For some, this means their healthcare plans cost more than their mortgage payments. Already, 1.4 million people have lost their healthcare coverage funded by the ACA. As the bill goes to the Republican-controlled Senate, estimates predict that as many as 20 million people will see their premiums double or triple.
 

The loss of these subsidies is poised to have a particularly stark impact on disabled Americans. Separate from the healthcare subsidies, Americans with disabilities can receive Social Security Disability Insurance (SSDI), through which people with a work history can qualify. They may also receive Supplemental Security Income, which is a cheque that averages at about $800 per month. Those on SSDI and not blind cannot earn above $1,690 per month to qualify. For those who are legally blind, the cutoff rises to $2,830. While SSDI recipients are automatically enrolled into the state-sponsored Medicare health coverage, those strict amounts have to cover food, emergencies and rent. This is a particularly tall order in cities like Atlanta, where the average rent is $1,930, or in New York City, where the average rent sits at $4,462 a month.
 

Without ACA coverage, disabled Americans will be forced to stretch these amounts even further to cover medical bills. Jermaine Greaves, a queer performing artist and founder of the Black Disabled Lives Matter group in New York City, is already feeling the difference. Greaves uses an electric wheelchair for mobility and has hidradenitis suppurativa, a chronic autoinflammatory disease where the body attacks hair follicles, leading to pus and boils. There is no cure, and regular treatment is required. Greaves currently receives SSDI. Insurance covered his monthly appointments with a physician, but with the subsidies expired, Greaves is being slapped with a $322 bill per session. 
 

”There has been stress in the past, especially when I was bed-bound and severely, chronically ill,” he says. Greaves, like many others, has had to resort to crowdfunding to cover medical and living expenses. “It’s an on-and-off roller coaster,” he says. “I’m not sure what to do.” 
 

The ACA subsidies were arguably not enough to help many to begin with. The Senate initially delayed the vote to the end of January, but it still remains stalled, and no clear date is on the horizon. Greaves and other LGBTQ2S+ disabled people are facing a daily struggle to find quality healthcare, despite their basic rights being protected under both the Americans with Disabilities Act (ADA) and the Civil Rights Act. Too often, this struggle is ignored by those without disabilities. In an interview with the Al Jazeera podcast The Take, disability justice educator Imani Barbarin stated, “People don’t really care if disabled people die.”
 

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According to the Movement Advancement Project, around three to five million LGBTQ2S+ people in the United States live with at least one disability. The range is that large because of evolving understandings of disabled experiences. “The definition of disability has evolved over time,” says Charles Catherine, vice-president of Corporate & Government Relations at the National Organization on Disability. “I like to remind people that you’re considered disabled if your condition affects one or more major life activities.”
 

The desperate need for healthcare, as well as personal safety, is driving many queer and trans people to relocate to “safe haven” states like New York, Illinois, New Mexico or Washington. These all have “shield” or “refuge” laws that guarantee healthcare for LGBTQ2S+ patients, especially trans individuals. “We’ve had a host of individuals who have gone from our D.C. site to our New York site,” says Sage Rivera, chief strategy officer at Destination Tomorrow, a multi-city organization that provides necessary and empowering resources to LGBQT2S+ clients to avoid crisis situations. “Those who have come up from Tennessee, Alabama and things like that have come to our sites as this Rainbow Underground Railroad.”
 

This does leave a conundrum for queer and trans disabled folk whose government-enforced poverty makes it hard to survive, let alone travel. Catherine and others call for phasing out Section 14(c) of the Fair Labor Standards Act, a 1983 law that permits companies to pay disabled employees sub-minimum wages. This solution is nowhere near perfect as it leaves the burden on individuals to find healthcare coverage, but it could potentially permit queer, trans and other disabled people more options when it comes to selecting insurance and being able to travel to safe haven states or receive better coverage from their employer.
 

As the Senate continues to stumble on the subsidy extension, states like New York are circulating universal healthcare bills. Such laws would affirm the humanity in everyone, regardless of disability or sexual identity, and ensure that this healthcare crisis doesn’t happen again. 
 

“If the right system is in place then not only will we contribute but we will bring something completely new to the table,” says Catherine.
 

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