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Department of Insurance says insurers can’t discriminate “based on gender identity”

Wednesday, Jul 30, 2014

* From a July 29th press release…

The Illinois Department of Insurance (DOI) today issued guidance clarifying that under the Affordable Care Act (ACA) and Illinois state law health insurers may not discriminate based on gender identity and related medical conditions. The guidance reminds insurers that exclusions and denials of coverage on the basis of gender identity are against the law.

“This is an important step to ending discrimination in Illinois,” DOI Director Andrew Boron said. “Transgender individuals are entitled to the same access to health care as everyone else. Health insurance policies that discriminate against a group of people, or based on any medical condition, will not be tolerated in Illinois.”

With the issuing of this guidance to insurers through an agency Bulletin, Illinois joins a handful of other states which have taken steps to bar discrimination in healthcare against transgender individuals.

“I applaud DOI for working to make certain that all Illinois citizens are given equal access to necessary healthcare services and that people are treated fairly and without discrimination,” State Representative Greg Harris (D-Chicago) said.

“I commend DOI Director Andrew Boron and Governor Pat Quinn Pat for this action which demonstrates that the state of Illinois is strongly committed to fighting discrimination in healthcare against any member of our population,” Illinois Human Rights Department Director Rocco Claps said. “Access to healthcare is a fundamental human right, and no one should face discrimination in their healthcare needs because of their gender identity.”

Under both federal and state law, if a health insurer covers certain services when medically necessary, such as a breast mastectomy or hormone therapy, it cannot deny those services for a transgendered person solely on the basis of that person’s transgender status or gender dysphoria. Currently, some insurers have broad exclusions for gender identity treatment and services. The guidelines issued today prohibit insurers from excluding services that target transgender persons or persons with gender dysphoria. Today’s announcement calls for an end to this disparate treatment of transgendered individuals.

DOI will be reviewing individual and small group policies offered under the ACA for 2015 to ensure compliance with anti-discrimination laws.

* AP

“This guidance helps ensure parity in health care coverage, making certain that services such as mental health care, cancer screenings and hormone therapy are routinely covered for transgender people when the insurer provides those services to non-transgender policy holders,” John Peller, interim president and CEO of the Aids Foundation of Chicago, said in a statement.

However, some question the move. The Illinois Family Institute’s Executive Director David Smith said the guidelines put some religious business owners in a position that forces them to compromise their faiths.

“To succumb and be made to submit to a rule that violates their freedom of conscience,” Smith said.

* Windy City Times

Transgender people often face discrimination when seeking insurance coverage of medically-necessary treatments prescribed by their physicians, even though such treatments are routinely covered for others. For example, hormone therapy and regular blood tests to guard against any negative medical consequences are routinely covered for many people, such as post-menopausal women, but are currently denied to many transgender people. Likewise, breast reconstruction surgery is routinely covered for women after surgery for breast cancer, but is routinely denied for transgender people, even if ordered by a physician.

There are many other medical procedures and treatments that are covered routinely each day — from surgery to mammograms to Pap smears — for non-transgender people that are often denied to transgender people, even though they are prescribed by a physician as medically-necessary treatment.

The Department of Insurance bulletin says such denials are discriminatory and not permitted under existing law. In recent months, insurance authorities in Oregon, California, Colorado, Vermont, Massachusetts, Washington and the District of Columbia all have made similar statements, making clear that health insurers in those states cannot discriminate on the basis of gender identity. The American Medical Association, the American Psychiatric Association, the American Psychological Association, the American Academy of Family Physicians and other national medical organizations all have called for an end to insurance discrimination based on gender identity. […]

The bulletin from the Department of Insurance cites three laws that prohibit discrimination against transgender people: the Affordable Care Act, the Illinois Human Rights Act and the Illinois Mental Health Parity Act. The bulletin explains that a plan may not be certified in Illinois ( a prerequisite to a plan being marketed and sold in the state ) if the plan discriminates against transgender people.

- Posted by Rich Miller        


16 Comments
  1. - Precinct Captain - Wednesday, Jul 30, 14 @ 12:18 pm:

    Good news


  2. - OneMan - Wednesday, Jul 30, 14 @ 12:25 pm:

    Sorry IFI, I actually see the logic to some degree in the Hobby Lobby ruling in part there are other laws that have existed for a while dealing with family planning activities and treatments.

    But, no you can’t limit treatment due to gender identity.

    Call me a hypocrite on this and I suspect many will, but I just can’t see that.


  3. - Formerly Known As... - Wednesday, Jul 30, 14 @ 12:27 pm:

    The ACA does say, very clearly, that one can not discriminate on the basis of gender. That is good. That is proper. That is equal.

    Yet, a number of gender based inconsistencies have also been established in terms of coverage requirements under the ACA.

    For example, female “sterilization procedures” are covered but not male vasectomies. Diaphragms, sponges and female condoms with a doctor’s prescription are covered but not male condoms under any circumstances. There are a number of such examples in the formal regulations published in the Federal Register http://webapps.dol.gov/federalregister/PdfDisplay.aspx?DocId=26927

    We should be consistent for everyone, regardless of gender and regardless of whether they are M, F or T.


  4. - OneMan - Wednesday, Jul 30, 14 @ 12:51 pm:

    FKA

    I think most insurance plans cover the big V as it were…


  5. - Empty Chair - Wednesday, Jul 30, 14 @ 1:24 pm:

    Boron is a top notch DOI Director - this is just another reason why.


  6. - Demoralized - Wednesday, Jul 30, 14 @ 1:36 pm:

    ==The Illinois Family Institute’s Executive Director David Smith said the guidelines put some religious business owners in a position that forces them to compromise their faiths.==

    This mantra is getting really old. At some point in time people have come to believe that their religion gives them carte blanche in discriminating. They are totally bastardizing the protections of the 1st Amendment, turning it into a “free pass” to not do things they don’t happen to like. I really wish they would shut up because they are giving other religious people a bad name with their hate campaigns.


  7. - John A Logan - Wednesday, Jul 30, 14 @ 1:58 pm:

    The Brave New World continues.


  8. - Anonymous - Wednesday, Jul 30, 14 @ 2:30 pm:

    - Demoralized - Wednesday, Jul 30, 14 @ 1:36 pm:

    Absolutely ! You wrote almost exactly what I was planning on posting. People who continue to hide behind their religion as an excuse to avoid laws that protect/benefit others of actions that they disapprove of are just practicing “holy” discrimination. Maybe a bit more reading of their hold books would give them insight on tolerance, if not compassion, for others.


  9. - Roadiepig - Wednesday, Jul 30, 14 @ 2:34 pm:

    Anonomous at 2:30 was me . iPhone problems. Also it should read holy books, not hold books. Sorry


  10. - walker - Wednesday, Jul 30, 14 @ 2:47 pm:

    Since it is so obviously already the law, I thought this announcement was purely political. No insurance company would ever think of acting otherwise.

    Then IFI spoke up and proved me wrong again.

    Ideologues want to be free to ignore the law when “God is on our side.” They have that freedom now, and they should accept the criminal penalties that come along with their choices.


  11. - 4 percent - Wednesday, Jul 30, 14 @ 4:22 pm:

    This is a political statement at its finest considering its already covered under state and federal law!!!

    From their own press release… “Under both federal and state law, if a health insurer covers certain services when medically necessary, such as a breast mastectomy or hormone therapy, it cannot deny those services for a transgendered person solely on the basis of that person’s transgender status or gender dysphoria.”

    What’s next - an advisory question on the state ballot requiring that insurance policies cover birth control?


  12. - Precinct Captain - Wednesday, Jul 30, 14 @ 5:11 pm:

    ==- Anonymous - Wednesday, Jul 30, 14 @ 2:30 pm:==

    It’s been about discrimination for the Religious Right for decades, all the way back to when the founders of the Religious Right fought for racial segregation.

    4 percent, try learning how to read: Currently, some insurers have broad exclusions for gender identity treatment and services. The guidelines issued today prohibit insurers from excluding services that target transgender persons or persons with gender dysphoria. Today’s announcement calls for an end to this disparate treatment of transgendered individuals.


  13. - Maria - Wednesday, Jul 30, 14 @ 6:48 pm:

    I used to be against Transsexuals and thought that they were sick people. This changed when I met my good friend Juanita. I did not know about her past until I was friends with her for over two years. One night she started to cry and through those tears told me about her reassignment to a girl. I was shocked.

    At first I did not accept it and was mean to her. After all, we tried to dresses together.

    Many months later after realizing that she was truly a good friend and not out for some sick thrill. I apologized and we are closer then we were before.

    She is truly a girl as am I.

    Sex reassignment is not about some sick thrill. It is about being the sex that they have always felt that they are.

    My friend is lucky. Her family accepts her. They did not at first but after she had the surgery and they saw how happy she became, they realized that it was the only thing that she could do to be happy. She was a very depressed child. I was upset with them for a while when I found out because they never told me but they said that it was her choice to tell anybody that she trust.

    She did lose most of her friends but she made new ones.

    She even has a boyfriend.

    She opened my mind and I am now embarrassed that I was so naive. I write this just to tell others to not judge these people who could be a friend without first finding out what they really went through to become the person that they are.

    If I knew her before the surgery, I would have been one of these people that did not accept her. I happened to get to know her before knowing about her transition. She gave me the opportunity to see what a wonderful friend she is before the negative judgments could set in.


  14. - Along 64 - Wednesday, Jul 30, 14 @ 8:12 pm:

    Empty Chair, are you and I thinking of the same Andy Boron? The guy couldn’t carry McRaith’s luggage.


  15. - Somewhere - Thursday, Jul 31, 14 @ 7:08 am:

    Boron a top notch Illinois Department of Insurance Director? I agree with Along 64. This guy is a joke for that Department.


  16. - Crista - Monday, Aug 11, 14 @ 12:03 pm:

    Will this also apply to those of us who are TS and are on Medicaid, Medicare etc. ?
    I hope so. This is good news Illinois is once again ahead of the curve on human rights…


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