Navigators, assisters, and certified application counselors are the unbiased people who are there helping consumers understand what the Affordable Care Act means for them and the new insurance options available to them through the law. We want to elevate their voices to share the experience of enrolling people and asked enrollment specialists to share their experiences with us in their own words. You can learn more about our work on Outreach and Enrollment here.

As a Navigator working for Planned Parenthood of Northern New England in New Hampshire (PPNNE), I have had the pleasure of connecting many consumers to health insurance for the first time. These experiences have allowed me to see firsthand the positive impact the Affordable Care Act has had on people who were previously locked out of the health care market. Nevertheless, there are still populations that are unable to fully benefit from the law. One population that I’m currently working with is the LGBT community, and particularly transgender people.

During this second open enrollment period, PPNNE developed a partnership with Out2Enroll, a national initiative to connect the LGBT community with new health insurance options under the Affordable Care Act. All of our assisters attended Out2Enroll’s LGBT cultural competency training, which covered enrollment questions and issues that frequently arise for LGBT community members. Our organization is now recognized as an LBGT-friendly assister on Out2Enroll’s enrollment assistance webtool, where LGBT individuals can search by zip code for assisters in their area.

Since PPNNE became a recognized LGBT-friendly assister organization, I have met with various consumers who recognize my office as a “safe place” that offers reliable and confidential assistance. Consumers have felt comfortable disclosing their HIV status during their enrollment appointments, or discussing their concerns about getting affordable coverage for their same-sex partner. In these instances, I guide consumers through the ACA’s non-discrimination provisions to educate them on affordable options that will not exclude them due to a pre-existing condition or their sexual orientation. Here in New Hampshire, we are fortunate that our expanded Medicaid program covers individuals living with HIV/AIDS, who previously would have had to wait until they were sick enough to qualify for coverage.

Despite these important non-discrimination provisions, transgender people looking to find coverage for hormone therapy, surgeries, or other important transition-related health care needs, often still must navigate a challenging process to find accessible and affordable options, especially if they are low-income consumers. It’s one of the reasons that we wanted to participate in Out2Enroll’s training- to ensure we could effectively communicate what coverages (and limitations) LGB and especially transgender people now have available under the ACA.

As I continued working with members of the LBGT community, I wanted to learn more about LGBT issues so I could offer better assistance. My research led me to wonderful resources offered by organizations such as Out2Enroll and the Gay and Lesbian Medical Association (GLMA). Through this process, I discovered some exceptional publications developed by Gay and Lesbian Advocates and Defenders (GLAD) that not only help consumers understand their rights regarding health care, but also provide best practices for successfully updating documentation. Furthermore, I learned that the work conducted by GLAD helped ensure that five of the six New England states now offer legal protection for all transgender persons. Regrettably, New Hampshire still lacks this explicit anti-discrimination protection, but progress is being made by the ongoing engagement of GLAD and New Hampshire’s Medicaid program as they aim to eradicate trans-exclusion policies.

As an LGBT-friendly assister, I realize there are still many consumers across my state who lack the knowledge and resources to advocate for their coverage needs. I know this situation is not unique to New Hampshire, so I wanted to share a few resources that improved my ability to assist consumers still facing barriers in the health care marketplace such as GLAD’s Transgender Legal Issues, the ACLU’s map of state non-discrimination laws, and PPNNE’s ACA for LGBTQ people flyer.

For more information on how your organization can participate in Out2Enroll’s LGBT cultural competency trainings, please visit or email Kendall Bills (

Katie Mae Stewart, Planned Parenthood of Northern New England