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Insurers in New York Must Cover Gender Reassignment Surgery, Cuomo Says

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Insurers in New York Must Cover Gender Reassignment Surgery, Cuomo Says

Post by Lorri Kat on Sat Dec 13, 2014 5:50 pm

http://www.nytimes.com/2014/12/11/nyregion/in-new-york-insurance-must-cover-sex-changes-cuomo-says.html?smprod=nytcore-ipad&smid=nytcore-ipad-share&_r=2

Insurers in New York Must Cover Gender Reassignment Surgery, Cuomo Says

Lee Albertorio felt like a man trapped in a woman’s body. After serving in the Air Force, he began taking hormones, which deepened his voice and made his physique more masculine.
He changed his passport to reflect that he was male, and last year he decided to have a mastectomy, known as top surgery. But his insurance company told him the operation was cosmetic and refused to cover it, he said Wednesday.
Now Gov. Andrew M. Cuomo is warning insurance companies that they will no longer be allowed to deny gender reassignment surgery or other treatment to change a person’s gender, like hormone therapy, if a doctor has deemed that treatment medically necessary.
In a letter being sent to insurance companies this week, the governor said that because state law requires insurance coverage for the diagnosis and treatment of psychological disorders, people who are found to have a mismatch between their birth sex and their internal sense of gender are entitled to insurance coverage for treatments related to that condition, called gender dysphoria.
“An issuer of a policy that includes coverage for mental health conditions may not exclude coverage for the diagnosis and treatment of gender dysphoria,” the governor’s letter says.
“That would change everything — I mean that sounds very good,” Mr. Albertorio said excitedly when told of the governor’s order.
The rule makes New York the ninth state to require the coverage, the Transgender Legal Defense and Education Fund, an advocacy group, said on Wednesday. The others are California, Colorado, Connecticut, Illinois, Massachusetts, Oregon, Vermont and Washington, according to the group. Washington, D.C., also mandates it.
The group said that most insurance policies currently exclude coverage for transgender treatment, and at best include it as a more expensive rider to a standard plan.
“This is an absolute sea change in the way that insurance for transgender people will cover their health care needs,” Michael Silverman, executive director of the fund, said. “This essentially opens up an entire world of treatment for transgender people that was closed to them previously.”
Leslie Moran, a spokeswoman for the New York Health Plan Association, the trade association for most health plans across New York State, said the industry did not object to having to cover gender dysphoria.
But she said the industry was concerned that the governor’s order could raise costs in the new year that were not contemplated during the recent round of rate-setting. And she said companies were concerned that the policy would open the door for other services that people might seek, claiming they were medically necessary for mental health reasons.
“It sets a precedent,” Ms. Moran said.
Benjamin M. Lawsky, the state’s superintendent of financial services, which regulates insurance, said he would “be very surprised” if the change led to a noticeable rise in insurance premiums, because the number of transgender people would be such a small part of the insurance pool.

“It will further solidify the rights of a group that probably weren’t always being treated as equal to everybody else, and that’s sort of fundamental to our system,” Mr. Lawsky said.
The new policy comes as the state is trying to negotiate a settlement in a class-action lawsuit seeking Medicaid coverage for sex-change treatments, and advocates said they hoped it was a signal that the state was going to approve that coverage as well. Mr. Lawsky said that State Senator Brad Hoylman, a Manhattan Democrat, had brought the issue to his attention in June, by pointing out that several other states had barred insurance companies from excluding gender-change treatment.
At that time, a review board of the United States Department of Health and Human Services had just ruled that transgender people could no longer be automatically denied coverage for sex reassignment surgeries under Medicare, reversing a policy in place since 1981.
Mr. Hoylman said this week that he knew people who had had to scrape together money from fund-raisers to pay for their gender reassignment surgery. “Nobody should be in that position in order to embrace such a fundamental aspect of their personhood,” he said.
Mr. Hoylman said he was hoping the governor’s directive signaled that the political climate was right to pass a “transgender civil rights act” in the state, guaranteeing that transgender people would not suffer discrimination in other areas like housing.
Mr. Albertorio, 30, a program coordinator at a nonprofit agency, wanted the top surgery so badly that he paid for it using $6,500 in loans and credit card payments. To complete his transition will cost at least $50,000, which for him is “pretty out of reach.”
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Re: Insurers in New York Must Cover Gender Reassignment Surgery, Cuomo Says

Post by Lorri Kat on Mon Dec 22, 2014 4:41 pm

http://www.nytimes.com/2014/12/19/opinion/insurance-fairness-for-transgender-people.html?_r=0

Gov. Andrew Cuomo advanced the cause of civil rights last week by declaring an end to a routine form of discrimination against transgender New Yorkers.
New York law requires insurance policies sold in the state to cover the diagnosis and treatment of psychological disorders. In a letter sent to insurance companies, Mr. Cuomo said insurers will no longer be allowed to exclude from that coverage hormone treatments, gender reassignment surgery or other steps deemed medically necessary by a doctor for a patient with gender dysphoria.
Since very few people choose to have the surgical procedure and the transgender community is a small part of the insurance pool, the change is unlikely to lead to an increase in insurance premiums. What it will do is relieve hardship and injustice for transgender individuals whose medical needs should be covered on the same basis as everyone else’s. Eight other states, including California, Illinois and Connecticut, already require such coverage.
This move adds to other efforts by Mr. Cuomo to protect transgender rights. The state on Tuesday announced proposed regulations that would provide coverage of medically necessary transgender services and procedures in the state’s Medicaid program as well, a step toward resolving a class-action lawsuit seeking that change. (The Obama administration this year reversed a 1981 policy that excluded gender reassignment surgery from coverage under Medicare.)
In June, Mr. Cuomo altered state policy to make it possible for transgender people to change the gender designation on their birth certificate to conform with their gender identity and expression based on a medical provider’s affidavit stating that “the applicant has undergone appropriate clinical treatment” for gender dysphoria, instead of having to provide proof of gender reassignment surgery. New York City, which has its own system for issuing birth certificates, has followed the state’s lead.
These steps are important, but New York State law still leaves room for discrimination against transgender people. In the coming legislative session, Mr. Cuomo should put his energies into a vigorous effort to pass the long-stalled Gender Expression Non-Discrimination Act, which would extend the New York statute that prohibits discrimination based on sexual orientation in employment, housing, education, credit and public accommodations to cover transgender people. Eighteen states already provide such protection. New York should join them.
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