Post submitted by Kat Skiles, former HRC Senior Marketing Strategist

Congress has voted to repeal the Affordable Care Act (ACA) — landmark legislation that provides access to healthcare for 22 million Americans, including millions of LGBTQ people. President Obama has blocked their attempts in the past, but next week President-elect Donald Trump will assume office — and all bets to protect the ACA are off. Here's what's at stake:

1. Under the Affordable Care Act, state marketplaces, health plans, and their employees are prohibited from discriminating against LGBTQ people. And insurers can’t charge more if you have a pre-existing condition, such as HIV or cancer.

2. Data shows that the LGBTQ community is less likely to have health insurance than the non-LGBTQ community. The Affordable Care Act makes new coverage options available to Americans, including those without access to coverage through a domestic partner or employer and those with pre-existing health conditions.

3. Access to affordable health insurance can not only provide access to care, but can help address health disparities that currently exist in the LGBTQ community and provide critical preventative care.

4. Without the protections guaranteed by the Affordable Care Act, many could lose coverage for lifesaving treatment for HIV and AIDS. Historically, people living with HIV and AIDS have had a difficult time obtaining private health insurance and have been particularly vulnerable to insurance industry abuses. The Affordable Care Act makes it easier for people living with HIV and AIDS to get coverage because they can’t be denied coverage due to pre-existing health conditions.

5. People with HIV and AIDS also face barriers to obtaining care from qualified providers. Consistent with the goals of the President’s National HIV/AIDS Strategy, the Affordable Care Act makes considerable strides in addressing these concerns and advancing equality for people living with HIV and AIDS. Investments in prevention, as well as improving care coordination help people living with HIV and AIDS get the treatment they need.

6. The Affordable Care Act has greatly expanded transition related healthcare coverage even to people who are not in ACA marketplace plans. Insurers cannot limit or deny coverage for services used for gender transition when those services would normally be covered when treating a non-transition related health condition.

7. The Affordable Care Act requires plans to provide all sex-specific preventative services available that are medically appropriate. This means that under the ACA a plan can't limit a preventative service like a pap smear, mammogram, or prostate exam, based on an individual's sex assigned at birth, gender identity, or their recorded gender. If a doctor determines that the preventative service is medically appropriate for a transgender individual and that individual meets the criteria for this recommendation and coverage requirements, the plan must cover the service without charging a copayment or coinsurance, even if the yearly deductible has not been met.