Cray played a central role in securing new nationwide LGBTQ nondiscrimination protections as part of the Affordable Care Act, partnering with the White House and the Department of Health and Human Services to create the Out2Enroll initiative to connect LGBTQ people with health insurance coverage options, assisting with the passage of the HOPE Act to make organ donation and transplantation more accessible to people with HIV, and drafting new provisions addressing the needs of LGBTQ youth for the Runaway and Homeless Youth Act.

[8] Among his federal policy work, Cray played a critical role as a founder of Out2Enroll, a nationwide initiative that connects LGBTQ people and their families with health insurance coverage options.

[9] Cray participated in an event at the White House to celebrate the enrollment of more than 8 million people into health insurance following the implementation of the Affordable Care Act.

Paulette Aniskoff, director of the White House Office of Public Engagement, said Cray's contributions to the Affordable Care Act were integral to the successful implementation of the law.

[10] On August 24, 2014, after receiving a terminal cancer diagnosis, Cray married LGBTQ rights activist Sarah McBride, who is also transgender.