Thursday, January 15, 2015

A Really Bad Bill

I always have to be vigilant about what bills are being proposed because the opposition is always trying to chip away on our successes. In December of 2013 the insurance commissioner issues a bulletin that said we were covered for all medically necessary healthcare procedures.

There was a bill that was just introduced in the Connecticut legislature that wants to overturn the commissioner’s decision,
Proposed Bill No. 5193
January Session, 2015
REP. SAMPSON, 80th Dist.

AN ACT CONCERNING HEALTH INSURANCE COVERAGE FOR GENDER REASSIGNMENT SURGERY.

Be it enacted by the Senate and House of Representatives in General Assembly convened:
That title 38a of the general statutes be amended to specify that health insurance policies delivered, issued for delivery, renewed, amended or continued in this state shall not be required to provide coverage for gender reassignment surgery or related surgical expenses.

Statement of Purpose:
To specify that health insurance policies delivered, issued for delivery, renewed, amended or continued in this state shall not be required to provide coverage for gender reassignment surgery or related surgical expenses.
This bill is so broadly written that if there were complications due to Gender Confirming Surgery it would not be covered. Suppose there was life threatening internal bleeding because of GCS the way this bill is written it could be argued that stopping the bleeding could be a “related surgical expenses.”

This bill is just mean-spirited and punitive. There is no reason why this bill is needed. The cost of GCS for the residents of Connecticut is negligible; studies have shown that the cost is less than a penny a day.

All the major medical organizations support insurance coverage for us; including the AMA, the APA, the WPATH, the Endocrine Society, and the American Academy of Pediatrics. In addition, the Centers for Medicare & Medicaid Services (CMS) have found that the GCS is medically necessary and the IRS tax court ruled that GCS is necessary and the cost can be deducted for tax purposes.

The commissioner’s decision was not arbitrary but based on research and was also mandated by PA 11-55 the laws that prohibits discrimination based on gender identity or expression, in the bulletin the commissioner states,
Public Act 11-55- The Connecticut legislature effective October 1, 2011 amended state antidiscrimination laws to specifically prohibit discrimination based on "gender identity or expression". The Act prohibits discrimination on the basis of gender identity or expression in employment, public accommodations, housing, credit, public schools, state contracts and numerous other areas. The Department finds the legislative intent to prohibit discriminatory practices based on gender identity and expression to extend to health insurance practices. Accordingly, medically necessary services related to gender dysphoria should not be handled differently from medically necessary services for other medical and behavioral health conditions.
So the inclusion of GCS wasn’t someting that the commissioner pulled out of a hat, it is based on a law by the state legislature when it passed the anti-discrimination law in 2011.

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