Four Big News Events Last Week!

It seems like Friday was a big news event day for the trans-community. There were two major announcements about medical coverage for us and two marriage equality court decisions that were handed down on Friday.

The first announcement was about a CDC ruling back in October where they said that for low income trans-women the free mammogram did not cover us, however, they now say we are covered. The NCTE released this statement,

NCTE Commends CDC’s Clarified Breast Cancer Screening Policy

The National Center for Transgender Equality (NCTE) commends the Centers for Disease Control and Prevention (CDC) for clarifying that its National Breast and Cervical Cancer Early Detection Program will cover screening for eligible transgender women and men.  The CDC deserves credit for consulting medical experts and community members and adopting an approach that is both fair and fact-based.

NCTE Director of Policy Harper Jean Tobin said, “Under the clarified policy, all transgender women who have taken hormones may receive breast cancer screening under the program, subject to other eligibility standards. Transgender men and gender non-conforming people with a female history continue to be eligible for breast and cervical cancer screening, if applicable.”

The CDC’s clarified policy comes in response to an uninsured transgender woman in Colorado who, in October 2013, was denied access to a breast cancer screening under a federal program administered by the CDC. Her provider pointed to an earlier CDC newsletter stating that its program excluded women who are “not genetically female.”

NCTE and the Human Rights Campaign swiftly condemned the provider’s actions and called on the CDC to investigate the case. NCTE Executive Director Mara Keisling said, “We applaud the CDC’s clarified policy and urge other public health programs, private insurance plans, and health care providers to adopt similar approaches.”

“The bottom line is that if you have a body part that needs screening, it ought to be screened regardless of your identity,” Keisling said.
So this about face will help many trans-women and trans-men have proper health care. 

The other big news is even more important and it a major step forward. The TransAdvocate reported that the Medicare appeals board found that,

The incomplete and inadequate state of the NCD [National Coverage Determinations – determines what is covered for Medicare] record with respect to the safety concerns cited in the NCD appears to stem, in part, from the substantial passage of time since publication of the sources on which the NCHCT [National Center for Health Care Technology] relied in recommending the exclusion of transsexual surgery. We note, for example, that the psychologist who submitted a declaration in support of the complaint cited a 1997 study as showing that “after 1985, surgical outcomes were far superior, owing to improvements in technique, shortened hospital stays and improvements in postoperative care.”
[…]
For the reasons explained above, we conclude that the NCD record is not complete and adequate to support the validity of NCD 140.3, “Transsexual Surgery.” Therefore, as required by the statute and regulations, we will proceed to discovery and the taking of evidence. As stated above, our ruling here does not address the ultimate question of whether the NCD as written is valid under the reasonableness standard in the statute and regulations.

That means that the Appeals Board believes that Gender Confirming Surgery (GCS) is medically necessary and should be covered by Medicare. This do not mean that health care for trans-people is automatically covered, the CMS [Center for Medicare Services] will now hold hearing to determine if coverage is warrantied.

This could have far reaching changes because many private insurance carriers base their exclusion on the face that Medicare does not cover GCS. So we may see the exclusions dropped from ERISA covered companies policies like the company where I use to work.

The other big news is that one federal court and one state court overturned state bans on same-sex marriages; in New Mexico their Supreme Court overturned their ban on marriage equality,

New Mexico legalizes same-sex marriage
NBC
By Barry Massey and Russell Contreras, The Associated Press
December 18, 2013

New Mexico became the latest state to legalize gay marriage Thursday as its highest court declared it is unconstitutional to deny marriage licenses to gay and lesbian couples.

Justice Edward L. Chavez said in a ruling that none of New Mexico's marriage statutes specifically prohibits same-gender marriages, but the state's laws as a whole have prevented gay and lesbian couples from marrying. The justices said same-sex couples are a discrete group that has been subjected to a history of discrimination and violence.

"Accordingly, New Mexico may neither constitutionally deny same-gender couples the right to marry nor deprive them of the rights, protections and responsibilities of marriage laws, unless the proponents of the legislation — the opponents of same-gender marriage — prove that the discrimination caused by the legislation is 'substantially related to an important government interest,'" Chavez wrote.

Of course the “family” organization are crying foul and vow to fight the court’s decision and pass a new law that will also get overturned.

In Utah a federal court overturned the state ban on marriage equality,

Federal judge backs same-sex marriages in Utah; state to appeal
LA Times
By Michael Muskal
December 20, 2013

A federal judge on Friday struck down Utah's same-sex marriage ban, making the state where the powerful Mormon Church has fought gay marriage the latest front in the legal battle over marriage rights.

In a 53-page ruling, U.S. District Judge Robert J. Shelby held that Utah’s law passed by voters in 2004 violates the federal right of gay and lesbian couples to due process and equal protection under the 14th Amendment to the Constitution.

“The state’s current laws deny its gay and lesbian citizens their fundamental right to marry and, in so doing, demean the dignity of these same-sex couples for no rational reason,” Shelby wrote. “Accordingly, the court finds that these laws are unconstitutional.”

Utah will appeal the ruling to the 10th Circuit Court of Appeals, Ryan Bruckman, a spokesman for the state attorney general's office, said in a telephone call to the Los Angeles Times. He said the state will also seek an emergency stay to prevent any gay marriages from taking place.

I see this case going all the way to the U.S. Supreme Court and what the court will rule is a crap shoot. If they allow the ruling to stand, marriage equality will be in all fifty states. Unlike Prop 8 ruling which only covered California. I think they will overturn court’s ruling because I believe the Robertson Court is for states’ rights. I think they will use their twisted logic to say that the 14th Amendment doesn’t apply to marriage.

If they uphold the decision I think all hell will break lose in the conservative states that have ban marriage equality. I can foresee outright disregard for the Court’s ruling.