A panel advising New York Governor Andrew Cuomo on the redesign of the state’s Medicaid program is considering recommending coverage for health care for transgender people.
New York could thus join several other states in providing all medically necessary care for transgender residents on Medicaid. Such a recommendation would be a welcome step forward in ending health care discrimination against transgender people, many of whom face severe discrimination in almost every area of their lives, including employment and housing.
Currently, New York’s Medicaid program specifically excludes coverage for sex reassignment surgery and hormone replacement therapy for transgender people. Exclusions that target the transgender community undercut the basic premise of health insurance coverage, which is to make medically necessary care accessible to those who need it. The American Medical Association, the Endocrine Society, and the World Professional Association for Transgender Health all recognize that transition-related care, including sex reassignment surgery and hormone replacement therapy, are safe and effective means of improving the health of transgender people. Unfortunately, few transgender people can afford such care on their own: according to a recent study, more than 20% of transgender New Yorkers make less than $10,000 a year.
Moreover, exclusions are often expanded in practice to include even routine medical care. According to the National Transgender Discrimination Survey released this year by the National Center for Transgender Equality and the National Gay and Lesbian Task Force, 17% of transgender New Yorkers have been refused medical care because of their gender identity or expression. Some were physically assaulted in doctor’s offices or emergency rooms.
Medicaid is a vital safety net for those priced out of buying their own coverage or who work jobs that do not provide health insurance benefits. The thousands of transgender New Yorkers in their state’s Medicaid program deserve a program that takes their health needs seriously. New York should set an example that shows other insurance programs riddled with transgender exclusions – including Medicare and many private insurance plans – how it’s done.