Metro Weekly

Wisconsin insurance board restores coverage for gender confirmation surgery

State will start covering transition-related procedures for employees

Wisconsin Department of Health Services – Photo: Facebook.

Wisconsin has restored coverage for gender confirmation surgery for the state’s transgender employees.

The state’s Group Insurance Board voted 5-4 on Wednesday to cover transition-related treatments for people who have been diagnosed with gender dysphoria. The surgeries will start being covered starting Jan. 1, reports the Associated Press.

“What we’re talking about is the improved health and well-being of our members for no cost,” board member Herschel Day, an associate professor at the University of Wisconsin-Eau Claire, said. Day added that providing the coverage shouldn’t impact premiums.

The board had previously approved coverage for gender confirmation surgery in 2016, but rescinded its decision in 2017 after receiving political pressure from Republican Gov. Scott Walker, a longtime opponent of LGBTQ rights.

Last year, a state consultant claimed that providing the coverage or other transition-related treatments would cost about $100,000 to $250,000 annually, assuming that two to five individuals were to pursue the surgery.

According to the AP, UnitedHealthcare, which is starting a Medicare Advantage program for state workers and retirees, agreed with the decision to cover the surgery. The company told the board that the state’s refusal to cover such procedures would cause the company to be out of compliance with federal Medicare rules.

Last year, the state was sued by the American Civil Liberties Union of Wisconsin on behalf of two transgender employees at the University of Wisconsin-Madison, who complained after they were denied coverage for surgical costs, even though their doctors had confirmed that the surgery was considered medically necessary.

One of the plaintiffs, Alina Boyden, was forced to forego gender confirmation surgery, while the second, Shannon Andrews, was forced to pay $21,000 in out-of-pocket expenses. Both women claimed that the denial of coverage violated their rights under the Equal Protection Clause of the Fourteenth Amendment, and under several other federal laws prohibiting discrimination based on sex.

Last month, a federal judge ruled, in a case brought by two other state residents, that Wisconsin also can’t ban Medicaid funds from being used to pay for gender confirmation surgery.

John Riley is the local news reporter for Metro Weekly. He can be reached at jriley@metroweekly.com

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