New York State Acts to Remove Medicaid Ban on Transgender Health Care
Department of Health Proposes Regulation to Ensure Transgender New Yorkers Have Access to Certain Medically Necessary Care
December 16, 2014 - We are happy to report that New York State Governor Andrew Cuomo and the New York State Department of Health have proposed a new regulation that would end the 16-year-old exclusion of transgender health care under New York’s Medicaid program.
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The new regulation would strike a 1998 regulation which states that coverage “is not available for care, services, drugs, or supplies rendered for the purpose of gender reassignment….” Last year, TLDEF submitted a 38-page letter urging the state to rescind the 1998 regulation. The new regulation, while proposing coverage for hormone therapy and certain surgical procedures, still excludes other treatments that may be medically necessary for some people. And it continues to exclude coverage for anyone under 18-years-old. The new regulation is subject to a 45-day comment period before it can take effect.
“We applaud the Cuomo Administration for taking this important step. But we call upon it to remove all restrictions for medically necessary transgender health care, including care for transgender youth. Transgender New Yorkers suffer because their health care needs are excluded from New York’s Medicaid program. This exclusion is rooted in bias, and serves only to harm some of the most vulnerable people in New York,” said TLDEF Executive Director Michael Silverman. “While this new regulation will dramatically improve the lives of many transgender New Yorkers by ensuring that they receive the medically necessary care that they need, it does not address all of the medically necessary health care needs that transgender people have. And it continues to exclude transgender youth. We look forward to working with the administration in the coming weeks to remedy this.”
TLDEF works with many transgender community members who receive health insurance through Medicaid. Several voiced support for ending the discrimination they face:
“I have been through a lot of tough times just trying to be myself. I was beaten as a child for being transgender and later kicked out of my home. It hasn’t been easy,” said 33-year old Brooklyn resident Athena Nefertiti Francis. “Because I am transgender, Medicaid has denied me the medical treatment I desperately need to live as my true self. This has added even more hardship to my journey. Ending this exclusion will improve my life and the lives of so many others like me. I am glad that the state is acting to change this rule.”
“I’ve known that I’m male for as long as I can remember. I just want to be comfortable in my own skin,” said 25-year-old Yonkers resident Adam Ramos. “I need to transition and for me that means being able to get the health care I need through Medicaid which is my source of health insurance. I am happy that the state is finally taking action to help me get the medically necessary care I need to be the person I am.”
“I'm uncomfortable in my body every day because New York’s Medicaid program denies me access to the health care I need,” said 27-year-old Brooklyn resident Alexis Velazquez. “Without this care I have been very depressed and have even developed an eating disorder. I have known I am transgender since I was 8-years-old and I faced a lot of teasing and name-calling as a child. But despite many hardships, I have never given up and I am relieved to know I won’t have to wait much longer to get the medical care I need to be the true me. I have no doubt that my life will improve.”
“I’ve overcome a lot of challenges, like enduring a religious counselor who told me that being transgender is a sin. Luckily I found a supportive therapist who helped me accept myself,” said 22-year-old Queens resident Mike Edgardo Altamar. “Being transgender is a vital part of me. Continuing to transition means getting the health care I need. The more comfortable I feel in my body, the happier I’ll be as my true self. It’s very important to me and people like me. Our health care should be covered because it is an absolute necessity for our well-being.”
Health care related to gender transition has been widely recognized as medically necessary by organizations such as the American Medical Association, the American Psychological Association and the World Professional Association for Transgender Health. Once the regulation takes effect, New York will join California, Massachusetts, Oregon, Vermont, and Washington D.C., which cover transgender health care through their Medicaid programs. In May, the federal government also ended its decades-long exclusion of coverage for certain services related to gender transition under Medicare.
“In addition to the Cuomo administration, we applaud the Sylvia Rivera Law Project and Legal Aid Society, whose lawsuit challenging Medicaid restrictions helped bring about this proposed regulation,” Silverman said. “And we praise the robust advocacy efforts of Empire State Pride Agenda, Audre Lorde Project, GLAAD, the Lesbian, Gay, Bisexual & Transgender Community Center, and others, which have shined a light on the need for change.”
The introduction of this Medicaid regulation follows last week’s announcement that New York State law requires private health insurance companies to cover transgender health care on the same terms as other care. It also follows New York State’s and New York City’s revisions to their birth certificate policies for transgender people. Both have rejected surgical requirements and now issue corrected birth certificates when a licensed medical provider states that a transgender individual has received appropriate clinical treatment.
“New York is poised to become a model state when it comes to the protection of its transgender residents,” said Silverman. “But while the introduction of this new regulation signals a welcome change in transgender health care, it should go further to address all medically necessary transgender health care, including care for transgender youth.”
“Additionally, New York still lacks a comprehensive law protecting transgender people from discrimination. We cannot rest as long as transgender people can be fired from their jobs, evicted from their homes and denied basic public services just because of who they are. New York’s failure to pass a law protecting vulnerable transgender residents is inexcusable and we call upon the Cuomo administration and our state legislators to do everything in their power to remedy this,” Silverman said.