April 26, 2013
New Health Insurance Bulletin Clarifies Access to
Health Care for Transgender Vermonters
For Immediate Release
Contact: Jean-Denis Couillard, Health and Wellness Coordinator
RU12? Community Center
The Vermont Department of Financial Regulation (DFR), Division of Insurance, this week, issued a bulletin clarifying key protections for transgender people in Vermont. The bulletin provides a clear directive to insurers that health care plans may not exclude coverage for medically necessary services for transgender people, including gender reassignment surgery.
The bulletin rests on key protections in law prohibiting gender identity discrimination, as well as the important and controlling standard of medical necessity regularly enforced by DFR rule. Insurance companies must comply with the terms of the bulletin, and new insurance policy forms filed by insurers will not be approved if they exclude gender transition related care. The bulletin will impact a wide range of plans purchased by individuals and employers in Vermont, but does not regulate self-insured employer plans, which will continue to be subject to federal law.
“This is an important clarification of Vermont law. Many health insurance plans categorically exclude gender-transition related care for no reason other than stigma and bias, and that is wrong,” said Corey Mallon, member of the Vermont Equal Care Coalition, a coalition of community organizations and individuals who advocated for the trans-inclusive reform in health insurance coverage. “There is no principled reason for denying a transgender employee medically necessary health care.”
This bulletin confirms that discrimination against transgender people, including discrimination perpetuated by unfair insurance coverage, is against Vermont public policy. The bulletin states that “DFR is committed to ensuring that Vermonters do not face discrimination in accessing medically necessary health care benefits, including those based on gender identity and gender dysphoria. This is both a simple question of fairness and a matter addressed by existing insurance law and DFR regulation.”
“This bulletin is a momentous achievement, an achievement that rests not only on the work of the Equal Care Coalition, but on years of extraordinary efforts of many people in Vermont, and indeed across the country. We are extremely pleased that yet another barrier to receiving quality health care has fallen. Vermont Federation of Nurses and Health Professionals is proud to be part of the Equal Care Coalition, the group that helped bring this over the finish line”, said Mari Cordes RN, President of Vermont Federation of Nurses and Health Professionals.
“Vermont joins a growing number of states in ensuring that transgender people are able to get the care they need, when they need it. Data shows that eliminating discriminatory insurance exclusions does not drive up costs, and is invaluable for helping transgender people lead healthy and authentic lives,” added Andrew Cray, a policy analyst with the LGBT Research and Communications Project at the, Center for American Progress in Washington, DC. California, Oregon, Colorado, and the District of Columbia have released guidance recognizing that equal access to health coverage is supported by medical science, improves the health of transgender people, and does not increase costs. Ending arbitrary insurance discrimination against transgender people simply supports what expert medical professional organizations including the American Medical Association, the World Professional Association for Transgender Health and others have been saying for years: transition-related health care is medically necessary for many transgender individuals whose health and well-being depends on bringing their physical body into alignment with their gender identity, and determination of what care an individual patient needs properly rests with medical providers, not insurance companies.
Read the full bulletin here - http://www.dfr.vermont.gov/sites/default/files/Bulletin_174.pdf
Frequently Asked Questions – http://www.ru12.org/bulletin_faq.html