Empire State Becomes Ninth to Ban Transgender Health Exclusions

New York State today became the ninth state, in addition to the District of Columbia, to apply its existing laws to prohibit discriminatory transgender exclusions in many health insurance plans. New York joins California, Colorado, Connecticut, Illinois, Massachusetts, Oregon, Vermont, Washington State, and DC, as well as the federal Medicare program in taking action over the last two years to eliminate these arbitrary exclusions.

Today’s letter from the New York State Department of Financial Services, addressed to all insurers in the state, declares that, “An issuer of a policy that includes coverage for mental health conditions may not exclude coverage for the diagnosis and treatment of gender dysphoria.” Notably, New York relied on state and federal mental health parity laws to arrive at this conclusion, and becomes the second state (with Massachusetts) to reach this conclusion without an explicit gender identity nondiscrimination law applicable to insurance. Other states have interpreted nondiscrimination laws based on sex or gender identity, or general prohibitions on arbitrary or unfair insurance practices, ban trans exclusions.

New Federal Plans Take Modest Step On Trans Health

The National Center for Transgender Equality expresses our disappointment that virtually every Federal Employee Health Benefits (FEHB) plan has failed to update their coverage to stop excluding medically necessary healthcare for transgender federal employees. Disregarding OPM’s June 2013 invitation to insurance companies to drop discriminatory trans health exclusions, the majority of FEHB plans that were announced have retained these outdated and wrong trans health exclusions.

NCTE calls on the Office of Personnel Management (OPM) to take stronger proactive steps to end discrimination against their transgender employees and cover trans health care needs. We urge federal employees who have been denied necessary care due to an exclusion to immediately file an EEO complaint with OPM.

In June 2013, the Office of Personnel Management (OPM) provided notice to insurance companies who have Federal Employee Health Benefits (FEHB) plans that OPM will no longer require insurance carriers to have blanket exclusions on trans-related care.  Advocates, including NCTE, celebrated this change, which gave insurance companies the opportunity to modernize their health benefits ahead of open season that begins this month.

Win: Maryland Drops Insurance Exclusions for State Employees

The National Center for Transgender Equality (NCTE) celebrates a Maryland resolution ending transgender health care exclusions for state employees. The case, brought forward by FreeState Legal, settles a complaint on behalf of Sailor Holobaugh, a transgender state employee who was denied medically necessary care. FreeState filed an Equal Employment Opportunity complaint as well as a complaint with the Maryland Commission on Civil Rights, alleging the denial of health care coverage for a transition-related procedure was discrimination on the basis of gender identity.

Today’s settlement includes reimbursement for the employee’s surgery, but also requires removal of transition-related care exclusions from all state employee health plans. The settlement also creates a new comprehensive Gender Dysphoria Benefit in state employee health plans. The benefit covers all medically necessary transition-related treatment, including hormone replacement therapy and various surgical procedures.

“We applaud Maryland and the administration of Governor O’Malley for becoming the fourth state to ensure coverage of transition-related care for state employees, joining Massachusetts, Oregon and California, along with the District of Columbia,” said National Center for Transgender Equality Executive Director Mara Keisling.  The decision follows enactment of the Fairness for all Marylanders Act earlier this year, explicitly banning discrimination on the basis of gender identity and gender expression in employment, housing, credit, and public accommodations.

D.C. Government Announces Comprehensive Coverage for Transgender Residents

Today, D.C. Mayor Vincent Gray announced that public and private health insurance plans that the D.C. government regulates–including Medicaid, D.C. government employee insurance, and private plans sold on D.C.’s health exchange–are required to cover transition-related care.

The new announcement makes D.C. healthcare coverage the most comprehensive plans for transgender Americans in the United States, a direct result of concerted advocacy from local activists, the National Center for Transgender Equality, or NCTE, and the Center for American Progress and other allies.

“This victory reaffirms growing agreement among advocates and the medical community that D.C.’s healthcare nondiscrimination laws require that insurance cover medically necessary transgender healthcare,” said Andy Bowen, NCTE Policy Associate.

“This policy will make D.C.’s healthcare programs and insurance coverage the most comprehensive in the country for the full scope of health care that transgender people need throughout their lives,” said Andrew Cray, Policy Analyst at CAP’s LGBT Research and Communications Project. “But more importantly, this announcement tells transgender people in the District that their health matters.”

In a bulletin released today, D.C.’s Department of Insurance, Securities, and Banking, or DISB, explains that it will view “attempts by companies to limit or deny medically necessary treatments for gender dysphoria, including gender reassignment surgeries, to be discriminatory.” Beyond that, DISB affirms, “it is the position of the Department that treatment for gender dysphoria, including gender reassignment surgeries, is a covered benefit…”

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