Molly Redden, writing for Mother Jones, reports on the difficulties dealing with health insurance companies when your trans. The article looks at how the Obama administration is working to make health insurance coverage available to transgender Americans by removing barriers to care…
Health Insurance Companies Are Even More Horrible If You’re Trans
Here’s how the Obama administration is trying to fix that.
Last week, the Department of Health and Human Services proposed new rules to crack down on pervasive health care discrimination against transgender men and women. The draft rules address forms of discrimination that were banned years ago on paper but remain a constant feature in many transgender individuals’ dealings with doctors and insurance companies—from being refused basic services such as blood tests to not being reimbursed for health care screenings such as Pap smears or prostate exams.
If approved, the rules would force many health care providers and insurers across the country to provide transgender patients with the same medical treatments and level of care they provide to nontransgender people—parity that most insurers never even approach.
In a recent survey of transgender men and women by the National Center for Transgender Equality and National Gay and Lesbian Task Force, 19 percent of people polled reported that someone refused them medical care because of their gender identity. Twenty-eight percent had postponed medical care because of discrimination, and half reported that they had to explain transgender health issues to their own doctors. These practices have contributed to disproportionately negative health outcomes for transgender people compared with the general population, such as staggering rates of depression, suicide, and HIV.
A series of actions at the federal level to end such discrimination did little to change the reality for most transgender patients. When it passed in 2010, the Affordable Care Act included a provision that explicitly barred many providers from sex discrimination. In 2012, the Department of Health and Human Services clarified that sex discrimination included discrimination against transgender patients on the basis of gender identity. A federal court in Minnesota backed up that interpretation in March this year, giving transgender people the ability to sue. But states still have broad authority to determine what actually constitutes discrimination—leaving a substantial loophole when it comes to enforcing protections.
The rules proposed last Thursday do not compel insurers to cover the medical components of the transition process, such as hormone therapy and sex reassignment surgery. But Mara Keisling, the founder and director of the National Center for Transgender Equality, stresses that health care discrimination goes far beyond transition treatments. It can be as simple as “access to hospital rooms,” says Keisling. “Being placed with a roommate of the wrong sex.” Transgender patients have reported being forced to undergo a pelvic exam when going to the doctor for a sore throat or being grilled at length about their gender identity and sexual history when seeking treatment for a broken arm. Keisling adds that insurance companies routinely refuse transgender men and women sex-specific preventive care—such as mammograms or prostate exams. These rules would force insurers to cover whatever preventive services a doctor finds necessary, regardless of what gender is listed in the patient’s medical history.
Read the full report here at Mother Jones: