DC Introduces Comprehensive Health Care Coverage For Transgender People


Mayor Vincent Gray

Mayor Vincent Gray

Mayor Vincent Gray

Today, less than a year after the DC Department of Insurance, Securities, and Banking (DISB) issued a bulletin clarifying the meaning of gender identity nondiscrimination in insurance, Mayor Vincent Gray announced additional standards for health coverage that will improve health care access for transgender people in the District of Columbia.

Following today’s announcement, the District will have the most comprehensive policy in the nation when it comes to providing transgender people with the health care that they need to live healthy and authentic lives — including coverage for transition-related care. The policy applies to nearly all public and private plans throughout D.C., including:

  • Individual, small group, and large group private market plans. This includes all plans sold through the DC Health Link, which is the Marketplace established for the district under the Affordable Care Act. The only exception is self-insured employer plans, which are regulated by ERISA.
  • D.C. Medicaid. Medicaid coverage is particularly important for transgender residents in the District because, as Dr. Linda Elam remarked at the Mayor’s press conference, D.C.’s Medicaid program insures nearly one third of the District’s residents.
  • D.C. government employee plans . The District now joins the many employers — both government and private — who offer comprehensive coverage to transgender employees.

With today’s announcement, DC joins the increasing number of states, municipalities, and employers who recognize that equal access to health coverage is supported by medical science, improves the health of transgender people, and does not significantly increase costs.

In fact, the District’s policy may serve as a model for other states recognizing the importance of equal access to health coverage for transgender people. The standards articulated in the announcement today expressly tie the coverage that must be provided to transgender people to standards of care established by medical experts in the World Professional Association for Transgender Health (WPATH). By adopting the WPATH standards as the guidelines for medical necessity, DC policymakers have taken the important step of recognizing that the determination of what care transgender people need is best made by patients in consultation with their medical providers, rather than by insurance companies.

This groundbreaking policy is the direct result of partnership between Mayor Gray’s administration and advocates with the National Center for Transgender Equality, the Center for American Progress, and transgender residents of the District. It also follows years of work from local advocacy organizations, including the DC Trans Coalition, Casa Ruby, Gay and Lesbian Activists Alliance, Whitman Walker Health, and the Gertrude Stein Democratic Club.

Read the full announcement from the Mayor’s Office and bulletins from the Department of Insurance, Securities, and Banking, Department of Health Care Finance, and the Department of Human Resources.

Andrew Cray is a Policy Analyst for the LGBT Research and Communications Project at the Center for American Progress