The Supreme Court’s decision Thursday upholding the Affordable Care Act will affect access to healthcare across the LGBT community. People will not lose their health insurance because of HIV status or other pre-existing conditions, and transgender people cannot be denied coverage.

In its decision, the Supreme Court ruled that the penalty for not buying insurance under the “individual mandate” is a tax and is therefore constitutional.

While the ACA makes insurance coverage more widely available to the LGBT community, the ruling allows states like Texas to refuse federal money to expand Medicaid to cover more people unable to afford private health insurance.

Insurance should be more accessible once statewide insurance exchanges are created, but Texas has done little to begin creating those exchanges, banking on the ACA being declared unconstitutional. State exchanges will not be allowed to discriminate based on sexual orientation, gender identity or sex.

Dallas’ AIDS Interfaith Network called the decision a “major step forward in the fight against HIV/AIDS.

In a press release, AIN wrote:

By upholding the Affordable Care Act, ensuring more individuals can obtain health insurance coverage, the Court removed a major roadblock to ending AIDS in America.

People living with HIV will have access to the reliable health coverage they need to seek and maintain continuous care, without unnecessary worrying about interrupts in care because of inadequate coverage or inability to pay.

National LGBT organizations, with the exception of Log Cabin Republicans, praised the decision.

Human Rights Campaign President Chad Griffin said in a statement: “The Supreme Court’s decision means millions of Americans — including many lesbian, gay, bisexual and transgender people and their families — will be better served by our nation’s healthcare system.  The Affordable Care Act addresses a number of the barriers LGBT people face in obtaining health insurance, from financial barriers to obtaining affordable coverage to discrimination by insurance carriers and healthcare providers.  While there is a great deal more that must be done to ensure that the health needs of all LGBT people are fully met throughout the healthcare system, today’s decision is an important victory in the fight for healthcare equality.”

In their release, National Stonewall Democrats said: “The ACA goes a long way toward leveling the playing field for LGBT Americans to get access to quality and affordable healthcare. The LGBT community is disproportionately affected by certain conditions for which insurance companies routinely denied or discontinued coverage before the enactment of the ACA. This ruling upholding the ACA will ensure that all Americans will have better and more affordable healthcare in the future.”

However, Log Cabin Republicans called the ruling a victory for “tax and spend liberals.”

“By upholding even the most intrusive provision of Obamacare, the individual mandate, the court has enabled Washington’s addiction to big government and coercive taxes,” said Christian Berle, Log Cabin Republicans deputy executive director.

The National Center for Lesbian Rights wrote in its statement: “The state exchanges set up by the ACA — which create a marketplace for people to purchase health insurance — prohibit discrimination based on sexual orientation and gender identity in those exchanges. In addition, the law extends federal nondiscrimination protections to the healthcare system, including protecting people from discrimination based on disability status (including HIV/AIDS status) and discrimination based on sex, which has often been interpreted to include gender identity and gender nonconformity.”

Abbe Land, executive director and CEO of The Trevor Project, said: “The Trevor Project is grateful that the Supreme Court upheld the important provision in the Affordable Care Act that will enable millions of Americans, including at-risk LGBTQ youth to gain access to healthcare coverage.”

Mara Kiesling, executive director of the National Center for Transgender Equality said: “All the time, people tell me that their health care coverage has been denied or cancelled because they are trans or are living with HIV. Others tell me about doctors who refused to see them because they are trans. Fortunately, the Court looked at the health of our country with fairness and upheld the law ending the practice of denying or dropping coverage for pre-existing conditions and allowing other key provisions to take effect.”

To read the court’s full decision, go here.