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Minnesota says health insurers must end transgender discrimination

Although it's illegal, insurance companies sometimes deny claims due to gender identity.

Although it's illegal, insurance companies sometimes deny claims due to gender identity.

The state of Minnesota wants health insurance companies to quit screwing over transgender people. Last week the state government issued an official-sounding “administrative bulletin” putting insurers on notice that discriminating against transgender folks isn’t cool anymore.

If that sounds like something that probably should have been illegal already, that’s because it is. While Obamacare makes your free-market pal’s blood boil, a section of it bans health care discrimination based on sex and gender identity — the first federal law of its kind, according to the U.S. Department of Health and Human Services. Good stuff for the trans community, right? Except the discrimination is still happening anyway, says Joann Usher, executive director of Minneapolis-based Rainbow Health Initiative.

“Some of it I think is unintentional, perhaps not realizing the scope of the Affordable Care Act,” she says. “Some of it is clearly intentional. There’s a suspicion that by making this coverage available it’s going to cost insurance companies a lot of money.”

Insurance companies sometimes write transgender exclusion clauses into their policies. In 2012, a New Jersey woman won a landmark case against Aetna after the health insurance giant refused to pay for the trans woman’s mammogram even though her doctor recommended it.

The Minnesota “bulletin,” written by the Departments of Commerce and Health, reiterates what transgender advocates said the New Jersey woman’s case affirmed — that insurance companies can’t deny medically necessary procedures on account of gender identity.

“By this bulletin the state of Minnesota has said to insurance plans, we know that this exists and you have to abide by it or you can’t sell your insurance policies in our state,” Usher says.

The LGBTQ health and wellness advocate added that it also clarifies what treatments are considered medical necessary and should remove the complex criteria insurance companies made transgender people hit before agreeing to pay.

While the state’s crackdown declaration gives patients ammo to fire at insurance companies should their claims be denied, Usher isn’t counting on an overnight change. Although it may tidy up the wording of people’s health plans, she says there will be a considerable transitional period for insurers — and perhaps in turn, those hoping for hassle-free payments.

“The other piece is that this is not going to correct problems with individuals who are processing claims,” Usher notes. “So, we know that the actual implementation of this bulletin is going to take longer.”