California to Health Insurers: Don’t Deny Transgender Patients

California’s milestone healthcare protections entitle transgender people to the same access as everyone else. Only 47 states need to catch up.

Attorney Gloria Allred (not pictured) holds the passport of Canadian model Jenna Talackova during a news conference in Los Angeles, California April 3, 2012. Talackova, a transgender beauty queen who was dropped from the Miss Universe Canada competition b

Transgendered advocates such as Canadian model Jenna Talackova are creating a new frontier on the civil rights movement. (Photo: Mario Anzuoni/Reuters)

Matt Fleischer was awarded a Fund for Investigative Journalism grant for his series “Dangerous Jails.”

In a huge milestone for the transgender rights movement, the California Department of Managed Health Care (DMHC) issued guidelines this past Tuesday that ensure transgender medical insurance customers are extended the same healthcare coverage as anyone else.

The guidelines clarified once and for all that California’s Insurance Non-Discrimination Act of 2006, authored by former State Assemblyman Paul Koretz, applies to transgender individuals. If an insurance company authorizes a treatment for non-transgender individuals, it needs to extend that same doctor-perscribed treatment to the trans community.

“This is an important step in protecting the health of all Californians, including transgender individuals,” California Assembly Speaker John Pérez said in a statement after the guidelines were issued. “No Californian should be denied care and treatment because of their gender identity or expression. Implementation of California’s Insurance Gender Non-Discrimination Act (IGNA) is a simple matter of fairness and equality in health care.”

The directive applies to all HMOs and PPOs regulated by the DMHC.

In addition to the new guidelines, transgender patients will also now be allowed to file complaints with a state review board over denials of care.

“DMHC has an existing review process,” Masen Davis, executive director of Transgender Law Center, tells Take Part, “but trans people were not able to access that process because of widespread discrimination in the healthcare system. These guidelines now finally grant them that access.”

“If there has been a treatment that has been requested, there has been a treatment denied. It’s really important to realize almost every insurance company in the United States has a transgender exclusion stipulation.”

The issue of non-discrimination for transgender patients is no mere formality. A 2008 study conducted by Transgender Law Center found that 15 percent of transgender patients were denied treatments like pap-smears or prostate exams just because they were transgender.

Davis, of the Transgender Law Center, says the sweep of insurance company discrimination went far beyond gender-specific treatments.

“Insurance companies are in this business to make money,” says Davis. “So if there has been a treatment that has been requested, there has been a treatment denied. Over the years, we have heard from thousands of transgender people who have been denied insurance or basic care. This letter from the DMHC makes it clear: To comply with existing law, health insurance companies can no longer deny care to transgender patients because of who they are.”

At least, that is, in California.

The Golden State, along with Oregon and Colorado, are the only places in America that offer such healthcare protections to transgender individuals.

“I think it’s really important to realize almost every insurance company in the United States has a transgender exclusion stipulation,” says Davis.

In other words, in most of America it is still possible to deny someone insurance coverage because of that individual’s gender identity.

“All of us need access to medical care and medically necessary procedures,” says Davis.  

As of this week, three states down, 47 to go.

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