Can You Say Chicken?

There are seventeen states and the District of Columbia that have protection for transgender people and of those five states and the District of Columbia require coverage for trans-people including Oregon. Their insurance commissioners issued a letter say if you cover medical treatment for non-trans people you have to offer treatment to trans-people and example is if insurance covers vaginoplasty for a woman say that was in a car accident (which they do cover because it is deemed “medically necessary” and not cosmetic) they have to cover the surgery for trans-people because it is also “medically necessary.”

So given those facts, Oregon has chickened out in their coverage for Medicaid…

Oregon will cover some transgender services under Medicaid
Guidelines cover puberty suppression for gender dysphoria
The Bulletin
By Tara Bannow
May 29, 2014

At the beginning of 2015, Oregon will join the few states whose Medicaid programs cover gender dysphoria, acondition that occurs when a person’s gender identity conflicts with his or her sex. But, as with most things, there’s a catch.

The new guidelines ensure Oregon Health Plan beneficiaries will get psychotherapy, office visits and medications that halt the onset of puberty, which can be particularly traumatizing for transgender youth. Transgender is an umbrella term for people whose gender identity does not conform with their sex at birth. They won’t, under the current guidelines, get cross-sex hormone therapy or sex-reassignment surgery, which some advocates say are crucial for transsexual individuals, those looking to alter their bodies to make them congruent with their gender identity.
[…]
The Health Evidence Review Commission, the group that decides what’s covered under OHP, is currently considering coverage for hormone therapy and surgery for beneficiaries with gender dysphoria. The HERC process includes poring over the most recent and reliable research on the subject and hearing from doctors and advocates who specialize in transgender health.

Did you get that? Even though the insurance commissioner said you can’t discriminate, even though these organizations says it is medical necessary, American Medical Association, the Endocrine Society, the American Psychological Association, the American Academy of Family Physicians, and the World Professional Association for Transgender Health. Even though in December the Medicare appeals board found that there is sufficient medical evidence to show that GCS is medically necessary the Oregon Health Evidence Review Commission want to study it some more… can you say chicken. They don’t want to take that finial step and cover hormones and surgery.