AHCA Coverages

[SandraB]

Is this a misunderstanding on my part? As of 2014, I thought that the AHCA removed all discrimination towards transgender. But what is the purpose of that if the health insurance companies can still have all of the exclusions for care? I'm under one of the exchanges (OHIO), and just saw this morning that ALL tg care is excluded. This is primarily the only health care that I get during the year. My employer refused to cover me (I'm full-time) due to my gender I.D. So just what benefit is this to us? Can anyone shed some light on this for me? When I signed up, the individual plans did not offer any information regarding exclusions.

[tgchar21]

The "removal of discrimination" means they cannot use being trans* (or anything else besides age and tobacco usage for that matter, in which they can charge a certain amount more but not deny coverage altogether) as a pre-existing condition to deny you or charge you more for general coverage. It does not mean they have to cover the transition-related procedures themselves (including that would bring even more outcry from the general public at being forced to pay for the healthcare expenses of others).

[Jamie D]

Is this a misunderstanding on my part? As of 2014, I thought that the AHCA removed all discrimination towards transgender. But what is the purpose of that if the health insurance companies can still have all of the exclusions for care? I'm under one of the exchanges (OHIO), and just saw this morning that ALL tg care is excluded. This is primarily the only health care that I get during the year. My employer refused to cover me (I'm full-time) due to my gender I.D. So just what benefit is this to us? Can anyone shed some light on this for me? When I signed up, the individual plans did not offer any information regarding exclusions.

Welcome to the wild and wacky world of socialized medicine.

This is from The Advocate:

Third, the nondiscrimination section of the Affordable Care Act, coupled with federal health regulations that prohibit discrimination in the administration of any program that receives federal funding, has made big waves. The regulations specifically protect people from discrimination based on gender identity, in addition to a number of other categories, at the level of benefit administration. Is this an explicit mandate that insurance companies nationwide must pay for transition-related care in all health care plans? No. However, we believe that these nondiscrimination protections mean that a transgender person who is covered under a plan purchased through any state exchange, or any Medicaid plan, has the right to appeal any denial they receive from their insurance carrier that targets them as transgender people. For example, if an insurance plan covers hormone replacement therapy for, say, women in menopause, then selectively denying coverage for hormone therapy to a transgender person should constitute discrimination. If this happens (and we anticipate it will), people have the right to file a formal complaint with the Office of Civil Rights with the U.S. Department of Health and Human Services, who will investigate the claim.

(Emphasis mine)

http://www.advocate.com/politics/transgender/2013/11/01/how-obamacare-will-affect-trans-folks-and-families