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Transgender community worries about state insurance policy

ETF: Gender reassignment services not covered

Transgender community worried about...

LA CROSSE, Wis. - For the about 250,000 state and local government employees covered by the State of Wisconsin Group Health Insurance program, gender reassignment services, procedures and surgeries are no longer covered.

The Wisconsin Department of Employee Trust Funds (ETF) excluded gender reassignment procedures from state insurance programs until January this year, when those services were added based on an interpretation of an Affordable Care Act requirement.

But on Feb. 1, ETF  changed its policy back, meaning procedures, services and supplies related to surgery and sex hormones associated with gender reassignment are again not covered by state insurance programs.

Will VanRoosenbeek is the Pride Center director at UW-LaCrosse, helping the LGBT community on campus. He was looking forward to the January 1st change.

"I was excited we were finally to the point to allow transgender people that are part of the UW system and the state of Wisconsin to finally feel like they, you know, belong, that their medical care is as important as anyone else’s,” he said. "Now this is set back for people to say, ‘Hm, maybe Wisconsin isn't as progressive as we thought.’”

University of Wisconsin's human resources department notified staff of this change by email this week.

"I was already aware,” VanRoosenbeek said. “My concern was maybe not everybody was aware."

Without insurance covering his hormone treatments and surgery, VanRoosenbeek has paid out of pocket.

"We're talking about tens of thousands of dollars,” he said.

He’s worried, however, that many others can't afford it.

“That’s scary,” he said.

VanRoosenbeek said gender reassignment services are often necessary for mental health.

“The bigger piece is your body not matching your brain and your heart,” he said. “If we don't have access to the health care we need for that, it's very problematic.

An ETF document says part of the reason behind the change was an opinion from the Wisconsin Department of Justice, along with a Texas federal judge's injunction barring enforcement of the ACA provision extending anti-discrimination protections to transgender health services.

According to ETF Director of Communications Mark Lamkins, there is currently no data available on how many people used the coverage for gender reassignment procedures in the one-month window they were allowed.

Lamkins wrote that a consultant for the insurance board estimates there would have been an annual cost of $100,000 to $250,000 for transgender services of a total $1.3 billion premiums.

ETF declined a phone interview, and the UW System declined to comment.


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