I've included below the full press release from Michigan Coalition for Gender Equality, which includes comments from the Executive Directors of NASW Michigan and Michigan Psychological Association (the Michigan affiliates of National Association of Social Workers and the American Psychological Association.) Unfortunately the Michigan Messenger chose to truncate this information. The public support from allied health associations such as NASW Michigan and MPA will be important in entering into dialogue with BCBSM and the state insurance commission regarding the importance of coverage for these services.
Here is a link to the full release at Michigan Equality: http://eqfed.org/mieq/notice-description.tcl?newsletter_id=32157968&r=
While it is true that lots of insurance plans don't cover trangender transition-related services, a growing number now do. Indeed, I would venture to say that at this point probably all of the major health insurance carriers in the USA now have at least one employer for whom they have included such services. These include Aetna, many BCBS affliliates, Cigna, HealthNet, Health Partners, Medica, UHC-United Health Care, MegaLife, and some HMOs such as Kaiser. Nonetheless it is also true that all of these also have many plans which exclude such coverage.
Some forum readers wrote that neither Kaiser (HMO) nor Anthem BCBS CA cover these services. While this may be true for the plans each of the readers has, both of these companies have written plans with inclusive coverage, and both have internal medical guidelines regarding implementation of such coverage. (the University of California's staff plans with 232,000 combined enrollees all have inclusive coverage. Their options include an HMO option with Kaiser and Anthem BCBS PPO.)
Thanks to some incredible advocacy work by individuals in their workplaces, often with support of their LGBT employee resource groups, many insurance carriers now recognize that these services are indeed medically necessary. The difficulty is that in many states, and under the federal ERISA legislation which regulates insurance offered at larger employers, there is no clear legal mandate that carriers or employers offer coverage of all medically necessary services.
The importance of the HRC Corporate Equality Index should not be underestimated in the changes that we've seen in the last few years. Although many of us would like to have seen the CEI begin this effort much earlier and their timeline move faster, many employers have already negotiated coverage for 2010. Internal workplace advocates will need to start discussions right now if they expect to make changes to 2011 plans. Nonetheless, I expect that we will see many corporations moving to fully inclusive coverage within the next two years. If and when these changes happen they will be as a direct result of internal advocacy work done over many months, even years, by employees inside these organizations who have networked with others to make the changes take place. So many of us could contribute to making a real difference, but rarely can we succeed in isolation.
In unity, Andre
Full Press Release from Michigan Coalition for Gender Equality:
“Gender Equality Coalition Urges Insurance Regulators to Reconsider
Blue Cross Coverage Changes”
DETROIT -- The Michigan Coalition for Gender Equality expressed deep disappointment regarding changes to Blue Cross Blue Shield of Michigan (BCBSM) plans that will eliminate reimbursements for gender reassignment surgeries for new customers. The Michigan Coalition for Gender Equality (MCGE) includes Affirmations, American Civil Liberties Union of Michigan, Michigan Equality, Michigan Project for Informed Public Policy, Transgender Detroit, Triangle Foundation, and the National Association of Social Workers’ Michigan Chapter.
“We are concerned that BCBSM underestimates the profound impact of these medically necessary procedures,” said André Wilson of MCGE. “Gender reassignment surgeries can be a critical part of the transition process and these new exclusions will place many transgender individuals and their families at real risk.”
The American Medical Association, American Psychological Association, National Association of Social Workers, and World Professional Association for Transgender Health have called for coverage by public and private insurers of all medically necessary procedures for the treatment of gender dysphoria or transsexualism, including gender reassignment surgeries. Treatment delays or denials for such services often lead to more serious and expensive health problems, according to the AMA, which has also called exclusions of transgender-related services discriminatory. WPATH affirms that gender reassignment surgeries are “cost-effective, not cost-prohibitive” and can be “essential to achieving well-being for the transsexual patient.”
“Many people are unaware of the distress accompanying gender dysphoria and of the damage caused by insurance exclusions,” said Maxine Thome, Executive Director of NASW Michigan. “Research shows the effectiveness of treatment, and social workers see the difference firsthand. Access to services brings dramatic improvements in health status, as well as increased employability and social acceptance.”
MCGE members learned of the BCBSM changes from the Detroit Free Press which reported, “The changes do not affect 170,000 customers already in individual Blue Cross plans or with Blue Cross insurance through their employer. But they will affect thousands losing insurance as employers drop coverage or lay off staff.” The changes were approved by Michigan’s Office of Financial and Insurance Regulation without any opportunity for public comment or input.
“Excluding medically necessary gender reassignment surgeries endangers patients' psychological and physical health which strains the entire health care system, driving costs up for everyone,” says Judith Kovach, Executive Director of the Michigan Psychological Association. “We urge both BCBSM and the Office of Financial and Insurance Regulation to reconsider this benefit change.”