On Tuesday, April 26, 2016, the Wilton Manors City Commission discussed an agenda item regarding gender confirmation benefit options being added to the city’s employee healthcare plan. The discussion included personal testimonies from members of the audience. I was moved by the struggles and tribulations transgender constituents within and outside our community are experiencing as a result of rampant discrimination within the mainstream healthcare system. And while much of the discussion was on the financial cost of coverage to the city, cost to employees, and where the money would come from, an essential fact was overlooked.

It’s important to understand that when it comes to insurance coverage for transition-related care, there is wide disparity between the types of medical insurance that can be offered within the State of Florida. For example, private insurance may offer gender confirmation/reassignment surgery but discriminate when it comes to treatments such as hormone therapy. And while government programs like Medicaid and health insurance exchanges may not discriminate against transgender individuals, they are not required to include coverage for gender confirmation/reassignment surgery, either.  

In other words, just because an insurer WILL cover something doesn’t mean one’s specific plan will allow the benefit. Insurance companies can tailor the scope of coverage at their own discretion. We need protections and regulations at both the state and federal levels banning insurance discrimination against the transgender community.

Currently, only the District of Columbia and a handful of States, including California, Colorado, Connecticut, Illinois, Massachusetts, New York, Oregon, Vermont, and Washington, have formally issued bulletins banning transgender discrimination in health insurance. A few states including Maryland, Nevada, and Minnesota have “some or partial protections.” 

The fight for insurance equality and parity has to be at the state and federal levels, and we can help advance that conversation at the city level. That’s why I, with the unanimous support of my commission colleagues, moved for the city to adopt a resolution urging federal and state regulators to add transgender-related procedures and treatments to current standards of care.  It’s imperative that the city of Wilton Manors, a longtime proponent of LGBT rights, add its voice to this important issue in a very specific way.

The request is clear and direct - our state regulatory authorities and officials need to expand the definitions of health insurance coverage and critical care to include gender confirmation/reassignment and transgender-inclusive medical care. 

 

SOURCES:

California - Translaw.wpengine.com/wp-content/uploads/2013/04/DMHC-Director-Letter-re-Gender-NonDiscrimination-Requirements.pdf

Colorado – One-colorado.org/wp-content/uploads/2013/03/B-4.49.pdf

Oregon - Oregon.gov/DCBS/insurance/legal/bulletins/Documents/bulletin2012-01.pdf

Vermont - DFR.vermont.gov/sites/default/files/Bulletin_174.pdf

New York - NYtimes.com/2014/12/11/nyregion/in-new-york-insurance-must-cover-sex-changes-cuomo-says.html?_r=1

HHS decision - HHS.gov/dab/decisions/dabdecisions/dab2576.pdf

Section 1557 Patient protection and affordable act - HHS.gov/civil-rights/for-individuals/section-1557/index.html

Summary of HHS’s Proposed Rule - KFF.org/disparities-policy/issue-brief/summary-of-hhss-proposed-rule-on-nondiscrimination-in-health-programs-and-activities

State by state map of transgender coverage - http://www.transequality.org/issues/resources/map-state-health

– By Justin S. Flippen, Wilton Manors City Commissioner