You cannot be turned away or charged more for being lesbian, gay, bisexual, or transgender. You also can’t be denied coverage or charged more because of any pre-existing health condition, such as your HIV status. Insurers can’t limit how much they’ll spend on your medical care – over a year or over a lifetime.

Under the ACA, health programs that receive federal funding, such as Marketplace plans, Medicaid, and Medicare, among others, cannot discriminate based on sex. The Biden administration interprets these nondiscrimination protections to extend to cover sexual orientation and gender identity. Notably though, the legal landscape is continuing to evolve, including with respect to the intersection of these protections and religious liberty protections for providers.

Married same-sex couples can apply jointly for tax credits in the Marketplace. These tax credits help you pay the costs of your health plan. Tax credits are calculated based on your federal income tax filing, so Marketplaces must recognize same-sex marriages and base eligibility on a married couple’s income. In fact, married couples, including same-sex couples, must file a joint tax return to gain access to these tax credits. If you are not married – if you are in a domestic partnership, a civil union, or another relationship – you may still be able to get these credits but will need to apply for them separately as individuals instead of as a couple; depending on your state Marketplace, you may be able to use your individual credits to buy a family policy rather than two individual policies.