Health insurers operating in Oregon and California have been ordered to stop denying coverage to transgender members.
Although the states haven't required insurers to cover any specific medical treatments for transgender members, they told the insurers they must cover hormone therapy, breast reduction and cancer screening. Essentially, insurers must cover any procedure determined as medically necessary if they would cover that procedure for members who aren't transgender, reported the Associated Press.
The changes apply to insurers that cover about 7 percent of Californians and about 30 percent of Oregonians. But they don't apply to individuals on Medicare or Medicaid or Californians who receive health coverage through an HMO, Live Insurance News reported.
However, both California and Oregon officials explained the directive isn't a new policy, but instead a clarification of anti-discrimination laws passed in California in 2005 and in Oregon in 2007. The problem, advocacy groups say, is that insurers often deny coverage for services that aren't even related to gender, the AP noted.
"What this means is that trans Oregonians will have access to basic medically necessary care," Tash Shatz, trans justice program manager at Basic Rights Oregon, told the Washington Blade. "It really represents a sea change in terms of this issue."
To learn more:
- read the AP article
- see the Live Insurance News article
- check out the Washington Blade article