This is a time of tremendous risk and opportunity for LGBTQ people and the health care system. ‘Medicare for All’ and ‘Medicare for All Who Want It’ proposals are taking center stage as we head into the 2020 Presidential elections. There is growing awareness among academics, health professional associations and policymakers, of health disparities affecting LGBTQ people and the need for more emphasis on cultural competence in health professional schools and continuing education programs. At the same time, the Trump Administration and many State legislatures are continuing to attack Medicaid and the healthcare rights of LGBTQ people, particularly transgender and nonbinary people. Moreover, after surviving multiple attempts to invalidate the law in Congress and through the courts, the ACA is facing a new challenge in a more conservative Supreme Court. This workshop will examine the Presidential candidates’ proposals for healthcare reform – and opportunities for progress, or more setbacks, on the Hill and in the White House in 2021 and beyond. The panelists will review how LGBTQ people have actually fared under Medicare and Medicaid as they currently exist and what changes would be needed to achieve equal healthcare for all. The workshop will also consider how cost containment issues are essential to the goal of equal access to healthcare.  The panelists will also examine the gains for LGBTQ people that have been accomplished through the ACA, and how those might be affected by the pending litigation that seeks to invalidate the entire statute.