By John Riley on November 19, 2015 @JRileyMW
The majority of Maryland’s transgender residents will be able to have medically necessary health care treatments covered by insurance, following a groundbreaking announcement by FreeState Legal.
FreeState Legal, the civil legal aid organization that works on behalf of low-income LGBT Marylanders, announced on Thursday that CareFirst, the state’s largest health insurer, and Maryland Medical Assistance, the state’s Medicaid program, had removed exclusions that had heretofore prevented treatments for gender dysphoria from being covered, forcing many transgender individuals to pay out-of-pocket costs or go without the treatments related to gender transition.
Patrick Paschall, the executive director of FreeState Legal, says that the CareFirst victory for transgender residents stemmed from a lawsuit that FreeState Legal had filed on behalf of a client who was denied transition-related health care by CareFirst. The company later reversed its decision and agreed to cover that particular client’s health care costs because it was deemed medically necessary and was already covered under the client’s plan for reasons unrelated to gender transition.
“In our discussions with CareFirst, we raised the issue and informed them that if they continue to have these types of exclusions, we’re going to continue to have these types of legal claims,” says Paschall. “And they did their own internal analysis and found that it makes sense for them to remove the exclusion.”
The exclusion previously denied coverage for any “treatment leading to or in connection with transsexualism, or sex changes or modifications, including but not limited to surgery.” Under the new policy, that exclusion will no longer be included on any new health insurance plans sold by CareFirst, on the individual, small group and large group markets, as well as on the Maryland Health Connection, the insurance marketplace set up under the federal Affordable Care Act, starting on Jan. 1, 2016. For all existing health plans — including FreeState Legal’s own employee health plan — the removal of exclusion will occur upon the date that the health plan is renewed.
But Paschall notes that the exclusion may be continue in plans offered by large self-insured employers where the plan is administered but not sold by CareFirst. Still, the decision by CareFirst is quite sweeping, as Paschall says that estimates for the percentage of Marylanders who are covered by CareFirst range from as low as 70 percent to as high as 90 percent. This means that in 2016, a majority of Marylanders will be carrying insurance plans without the exclusions.
“The removal of this exclusion means that medically necessary care that transgender people need, in consultation with their doctor, will not be excluded solely because a person is transgender,” Paschall says, noting that FreeState is involved in ongoing legal actions being brought against other employers and insurers in Maryland. “All of the other health insurers in our state should make the same decision that CareFirst did and remove the transition-related care exclusions from their health care plans. … In addition, the state can follow the lead of other states and issue an insurance bulletin prohibiting transition-related care exclusions from existing in any health insurance plans sold in our state.”
Maryland Medical Assistance chose to remove its transition-related exclusions after FreeState Legal settled a claim brought against the state for such an exclusion in the state’s employee health benefits program. As part of the settlement, the state removed the exclusion and began providing a comprehensive health benefit for transition-related care. FreeState then approached the state’s Medicaid agency and asked that the Medicaid program be updated to fall in line with the benefits that are already offered to state employees.
As a result, the Maryland Department of Health & Mental Hygiene has informed FreeState Legal that it has finalized a regulation proposed in January that removed an exclusion barring coverage for “gender change or sex reassignment procedures” under Medicaid. The finalized regulation, which was first proposed under former Gov. Martin O’Malley’s (D) administration, and then allowed to move forward under Gov. Larry Hogan (R), will take effect on Dec. 10.
Thursday’s announcement by the Department of Health & Mental Hygiene makes Maryland the tenth jurisdiction in the country to remove such exclusions from its Medicaid program. Other states that have taken similar measures are: Massachusetts, California, Colorado, Connecticut, Illinois, New York, Oregon, and Vermont, as well as the District of Columbia.
“The fact is that the Affordable Care Act prohibits discrimination on the basis of sex,” adds Paschall. “The federal government has interpreted that, consistent with other courts, to include a prohibition on discriminating on the basis of gender identity. We continue to believe that transgender discrimination, in the health insurance context, is a violation of federal law. So we have initiated and will continue to initiate legal actions to enforce that federal law against any insurers and employers who attempt to discriminate against transgender people.”
By John Riley on July 19, 2024 @JRileyMW
Elon Musk, the CEO of spacecraft manufacturer SpaceX, announced that he plans to relocate both companies from California to Texas in response to recent pro-transgender legislation.
The law that prompted Musk's tantrum, signed by Gov. Gavin Newsom (D-Calif.) on July 15, and scheduled to take effect in January, prevents school officials and teachers from "outing" students who identify as transgender or nonbinary to their parents.
"This is the final straw," Musk wrote on X, which he also owns. "Because of this law and the many others that preceded it, attacking both families and companies, SpaceX will now move its HQ from Hawthorne, California, to Starbase, Texas."
By John Riley on July 2, 2024 @JRileyMW
The Human Rights Tribunal of Ontario awarded an Indigenous transgender woman $35,000 in legal damages after a waxing salon denied her service.
In addition to the damages, an undisclosed amount in interest will be paid, caculated from the start of the case on March 17, 2018. More interest may be incurred if the owner of the salon fails to pay within 30 days.
The decision comes after a six-year legal battle between the woman, A.B., and Mad Wax Salon in Windsor, Ontario. A.B. called the salon to book an appointment for a leg wax but was refused because the only available staff member, a Muslim woman, refused to wax people assigned male at birth, citing religious beliefs.
By John Riley on July 17, 2024 @JRileyMW
After a Senate committee attached two amendments to the annual defense bill, the United States is closer to prohibiting coverage for gender-affirming care for transgender military members and transgender dependents of active-duty service members.
During a closed-door markup of the National Defense Authorization Act (NDAA), the Senate Armed Services Committee approved an amendment to "prohibit the use of funds available to the Department of Defense and any Department of Defense facility to perform or facilitate sex change surgeries."
It means that any transgender adult serving in the Armed Forces will not be able to obtain coverage for gender confirmation surgeries under TRICARE, the Department of Defense's health insurance program, and will be forced to pay out of pocket if they wish to pursue surgical interventions.
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