D.C. Moves To Protect Transgender Residents from Insurance Discrimination

Bulletin issued by DISB outlines parity in coverage for transgender consumers of health insurance

By John Riley
Published on March 19, 2013, 6:24pm | Comments

The District's Department of Insurance, Securities and Banking (DISB) has issued a bulletin prohibiting discrimination based on gender identity or expression by insurance companies who underwrite health-insurance policies in D.C.

The March 15 bulletin clarifies the District's Unfair Insurance Trade Practices Act, which makes it illegal to refuse to insure, refuse to continue insuring, or limit the insurance coverage of an individual based on gender identity or expression, among other characteristics. Under the clarification, private insurance companies that underwrite coverage for individual or group plans will have 90 days – meaning a deadline of June 15 – to file revised policies with DISB that eliminate any discriminatory language barring certain services to transgender individuals, explains Amy Loudermilk, deputy director of the Mayor's Office of GLBT Affairs.

The recent clarification is not a new mandate, notably, but simply provides parity to transgender individuals, allowing them access and coverage for the same services as non-transgender patients, according to Philip Barlow, associate commissioner for insurance at DISB. As Medicaid is a federal program, the District's gender-identity nondiscrimination rule does not apply to people on that program.

According to Sterling Washington, director of the Mayor's Office of LGBT Affairs, prior to the new directive being issued, some health insurance companies in the District have excluded transgender residents from receiving services that were approved for other patients, such as mastectomies for breast cancer, hormone-replacement therapy and high blood pressure medication. Now, transgender patients will be approved for such treatments.

Barlow says that ''cosmetic surgery'' is not covered by health-insurance plans, which, he says, means the nondiscrimination guidance will have no bearing on gender-reassignment surgery.

The directive comes a month after the Mayor's Office of GLBT Affairs informed DISB of discriminatory language in several District health-insurance providers' policies, Barlow told Metro Weekly. DISB, already in the process of implementing health-care reform, then issued the directive to clarify that insurers in the District cannot discriminate against particular classes of people.

The directive makes the District the third such jurisdiction in the United States, after California and Oregon, to prohibit discrimination in insurance based on gender identity or expression.