Health Advice



Physicians are uneasy as Colorado collects providers' diversity data

Markian Hawryluk, Kaiser Health News on

Published in Health & Fitness

“The best doctor to go to is someone who’s done the work to understand what it means to be a safe, affirmative practice,” said Jessica Fish, director of the Sexual Orientation, Gender Identity and Health Research Group at the University of Maryland.

Many health plans allow enrollees to search for providers who have such training but don’t identify which ones are part of the LGBTQ+ community themselves. Deciding to self-identify to patients or colleagues can be difficult and often depends on a provider’s circumstances.

“There are multiple variables that contribute to one’s comfort level and decision whether or not disclosure is safe for them,” said Nick Grant, a clinical psychologist and president of GLMA: Health Professionals Advancing LGBTQ Equality, formerly the Gay and Lesbian Medical Association. “In different areas of the country, it depends on what the climate is. National politics have influenced those conversations.”

Grant said the debate over transgender laws in conservative states like Florida and Texas has a chilling effect on doctors across the country, making them less willing to come out. In contrast, the moves toward culturally responsive networks being made by Colorado, he said, help signal that the state is much more protective of LGBTQ rights.

“I’ve never seen anything similar in the other states,” he said.

The new data collection requirement will apply only to Colorado Option plans, which become available in 2023 and are likely to enroll just a portion of the more than 200,000 people who purchase plans through the state’s health insurance marketplace. But state officials hope that health plans will use some of the same network-building strategies for their other plans.


Colorado’s approach has caught the eyes of other states. And as part of a new federal health equity initiative, the Centers for Medicare & Medicaid Services recently announced it would collect more demographic data — covering race, ethnicity, language, sexual orientation, gender identity, disability, income, geography, and other factors — across all CMS programs, which cover 150 million people.

“We have learned from bits and pieces of what other states have been doing and what the national leading experts have been talking about in terms of health equity and cultural competence, and we have synthesized that into something that we think is really leading the nation,” said Brown, the Colorado affordability programs official. “People are going to look at Colorado as an example.”


(KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.)

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