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‘A Matter of Fairness’: California & Oregon Require Transgender Health Coverage

Jan. 12, 2013 2:43pm
A Matter of Fairness: California & Oregon Require Transgender Health Coverage

Rachel Sorrow, a transgender woman, left, attends a therapy session with Dr. Dan Karasic, a psychiatrist with the Center of Excellence for Transgender Health, at San Francisco General Hospital. (AP/Marcio Jose Sanchez)

SALEM, Ore. (AP) — Regulators in Oregon and California have quietly directed some health insurance companies to stop denying coverage for transgender patients because of their gender identity.

The states aren’t requiring coverage of specific medical treatments. But they told some private insurance companies they must pay for a transgender person’s hormone therapy, breast reduction, cancer screening or any other procedure deemed medically necessary if they cover it for patients who aren’t transgender.

The changes apply to companies insuring about a third of Oregonians and about 7 percent of Californians, but not to people on Medicare and Medicaid or to the majority of Californians who are insured through a health management organization, or HMO.

Advocacy groups said the action is a major step forward in their long battle to win better health care coverage for transgender Americans.

“It’s just a matter of fairness,” said Ray Crider, a 28-year-old transgender man from Portland. “I just never felt that I was like anybody else. I see everybody else being taken care of without having to fight the system.”

Officials in both states said the new regulations aren’t new policies but merely a clarification of anti-discrimination laws passed in California in 2005 and in Oregon two years later.

Many health insurance policies broadly exclude coverage of gender identity disorder or classify it as a pre-existing condition. Transgender patients are often denied coverage for medical procedures unrelated to a gender transition, advocacy groups said, because insurance companies deem the condition to be related to their sex reassignment.

Some transgender patients also have trouble getting access to gender-specific care. A person who identifies as a man might be denied coverage for ovarian cancer screening or a hysterectomy. A transgender woman might be denied a prostate screening.

The state insurance regulators said those procedures, if covered for anybody, must be covered for all patients regardless of their gender.

Masen Davis, director of the Transgender Law Center in San Francisco, said he’s unaware of insurance regulators in any other state taking similar action.

The California regulations took effect in September and apply only to insurance products regulated by the California Department of Insurance. The agency primarily regulates preferred provider plans, or PPOs, that covered about 7 percent of the population in 2010, according to data from the California Health Care Foundation.

The agency that regulates California HMOs has discussed transgender care with consumer groups and health plans, “but no regulations have yet been proposed or adopted,” said Marta Bortner Green, a spokeswoman for the Department of Managed Health Care.

The Oregon Insurance Division issued its guidance last month in the form of a bulletin to insurers. It applies to commercial insurance companies that cover about a third of the state’s population; the rest are uninsured, on Medicare or Medicaid, or work for a large employer that’s self-insured.

“This is a very historic bulletin, and it really indicates that the tide is turning on this issue,” said Tash Shatz, transgender justice program manager at Basic Rights Oregon, an advocacy group.

Transgender advocates say gender reassignment, through hormone treatment or surgery, is medically necessary, and they’ve long fought insurance companies that argue the procedures are cosmetic. They hope the new state regulations will mean fewer procedures are refused and make it easier to appeal a denial.

The transgender community has picked up significant momentum securing health coverage in recent years. San Francisco in 2001 became the first U.S. city to cover sex reassignment surgeries for government employees. Seattle, Portland, Ore. and Berkeley Calif., have followed suit.

Large employers are increasingly offering coverage for a broad spectrum of care, including gender reassignment surgeries.

State regulators don’t have authority to force insurance companies to cover specific procedures, like hormone therapy or genital reconstruction. But they’ve told insurers that if they provide breast reduction for patients with back pain, they can’t deny it for a gender reassignment that’s been deemed medically necessary. Insurers could unilaterally exclude coverage of, say, breast implants, but it would have to apply to all policyholders equally, including breast-cancer patients.

“We’ve received the Oregon Insurance Division’s directive to implement this new mandate, and we are working to ensure that our members’ future coverage aligns,” Scott Burton, a spokesman for Regence BlueCross BlueShield of Oregon, said in a statement.

“We’re still assessing the impact of the ruling, and will continue to monitor state and federal guidance on this topic,” said Kathy Born, a spokeswoman for LifeWise, another large insurer in Oregon.

When Ray Crider heard the news, he danced around his apartment with his wife. A 28-year-old transgender man living in Portland, Crider fought a long battle to convince a previous employer to include transgender services in his policy.

Although he was insured, Crider paid thousands of dollars out of his pocket for testosterone treatment and mental health care before winning his fight for coverage of gender identity. He finally got a double mastectomy, covered by insurance, a year ago, he said, but not before the binder he used to flatten his chest required several emergency room trips because it constricted his breathing.

“This was one of the most incredible things that could ever happen,” Crider said, “to know that there’s a state full of people who won’t have to go through what I went through.”

In CONTROL, Glenn Beck presents a passionate, fact-based case for guns that reveals why gun control isn’t really about controlling guns at all; it’s about controlling us. Find out more HERE.

Comments (94)

1 2 3
  • RightThinking1
    Posted on January 12, 2013 at 6:01pm

    ““It’s just a matter of fairness,” said Ray Crider, a 28-year-old transgender man”
    I suppose that I am old-fashioned, but I would say that it is a matter of chromosomes. The wacko-left have been remarkably successful in redefining abnormal as normal, and vice versa. That, in and of itself, is societal rot, but to add to insult to destruction, the rest of us are financing it.

    Report this comment

    RightThinking1  
    • Brentley
      Posted on January 12, 2013 at 7:04pm

      You are correct in that assertion. To make ABNORMAL Normal is their goal. To make first Gay marriage legal, then recognize transgenders….and guess what comes next after that. Oh yes, PEDOPHILIA. They want to rot the country. Remove GOD, JESUS from the very core of life itself.

      These people have a SODOM and GOMORRAH type agenda. Everything is OK as long as it feels good to me.

      I have news for everyone…GOD IS NOT MOCKED. Every one of us will answer to GOD and let no one say otherwise. Just because a person or a group of people make a law that says this type of behavior is OK…IT IS NOT OK….IT IS SIN..plain and simple.
      The only one that can remove SIN is JESUS CHRIST. SALVATION is only through JESUS CHRIST. SIMPLE FACT!

      Report this comment

      Brentley  
    • Soulfire1975
      Posted on January 13, 2013 at 8:42am

      Morons! I mean seriously when they are convicted they lose their rights~!~

      Sad in a country when convicted felons have more rights then American citizens

      Report this comment

      Soulfire1975  
    • dmerwin
      Posted on January 13, 2013 at 9:23am

      If the conversion was such a good thing why is the subject in the photo at a psychiatrist??? If this is the trend then certainly, ALL cosmetic surgery is on the table.

      Report this comment

      dmerwin  
  • Imprimatur
    Posted on January 12, 2013 at 5:57pm

    I’m an individual living in an average body who desires to have a physique of an elite bodybuilder. I believe that I was born this way and therefore the government should make it mandatory for everybody else to pay for my physical transformation to occur as well as all the therapy associated with this morphological correction. It’s only fair.

    Report this comment

    Imprimatur  
    • right-wing-waco
      Posted on January 12, 2013 at 6:14pm

      Hey, I agree. I’m 65 and not so good looking anymore. I want to look like a 22 year old rock star and have woman fighting over me. It’s my RIGHT for the citizens of Cali to pay for it.

      Report this comment

      right-wing-waco  
    • Keatonc33
      Posted on January 12, 2013 at 9:30pm

      hmm… thats actually a good point.

      Report this comment

      Keatonc33  
    • Walkabout
      Posted on January 12, 2013 at 10:30pm

      Imprimatur

      Exactly.

      If it is about what we want or feel, then they owe me & it is going to cost more than their surgeries. Poor things are going to have to work double shift 365 days a year for the rest of their lives to pay for what I want. I want it all. Football, Baseball, track star, … I’ll cut the list short for the readers sake, but I want a lot.

      Report this comment

      Walkabout  
  • getourcountryback
    Posted on January 12, 2013 at 5:44pm

    Give me a FN break. If you have male parts you should get examined for male issues. I certainly hope they require mandatory mental health treatment as the federal government classify’s this as a “mental health” issue not a medical issue. Can’t have it both ways…..oh, I guess that is the point isn’t it? I want liposuction and bigger boobs; that should be paid for too, right?

    Report this comment

    getourcountryback  
  • ares338
    Posted on January 12, 2013 at 5:25pm

    Pick a sex and get there dumbass!

    Report this comment

    ares338  
    • Eastinfection
      Posted on January 12, 2013 at 10:04pm

      hey Mama
      take a walk on the wild side
      and the colored girls say…
      doo doop doop
      doop a doo
      doo doop doop
      doop a doo

      Report this comment

      Eastinfection  
  • bdandsl
    Posted on January 12, 2013 at 5:10pm

    You want to be a bum and not work, fine. You want to be a bum with kids and not work, fine. You want to be a freak and have your dick cut off, fine. You have every right to be anything you desire. Be any kind of freak you want to be – JUST DON’T SEND ME THE BILL!!!

    Report this comment

    bdandsl  
  • TheGrtDcptn
    Posted on January 12, 2013 at 4:48pm

    ‘The tide is turning on this issue.’

    The tide isn’t turning…it’s being forced, there is a difference…

    Report this comment

    TheGrtDcptn  
    • Walkabout
      Posted on January 12, 2013 at 9:26pm

      “When cross-dressing occurs for erotic purposes over a period of at least six months and when it causes significant distress or impairment, the behavior is considered a mental disorder in the DSM called transvestic fetishism.” -wiki

      Of course they want to force change. If you don’t accept them, that is accept them into your peer groups, they will be distressed & therefore they will have a mental disorder. It is that simple.

      If at work people don;t hang out with you at the water cooler or after work, because people do not approve of your lifestyle, that may cause distress. It happens to Christians, Jews, atheists, bikers, etc to one degree or another. But most of these people are comfortable with their choice, lifestyle & subcultures. So long they can get the work done at the job they can deal with a cold shoulder at work.

      One group cannot. They need affirmation forced by government edict, a campaign of social opprobrium (as much as they can muster).They are trying to force association so much so that free association does not exist or cannot exist if they get there way.

      Many of these people are not good with themselves unless 80% to 90% or more of the population approves of them. It hasn’t happened & thus the decades long campaign.

      You would not want to be this way or have your kid this way. You would try to find the cause & try to fix it. These people are now saying do not find the cause & do not fix it. How could you willing approve of such a subcult

      Report this comment

      Walkabout  
  • welovetheUSA
    Posted on January 12, 2013 at 4:40pm

    This is getting more and more sickening …….tax payer money for screwed up mindless idoits who want to play gender dice with their bodies…..pay for their mental heath would be the human thing to do. Worked around gays and these idoits for over 30 years……they are by far the most unstable humans on earth.

    Report this comment

    welovetheUSA  
  • gundylan
    Posted on January 12, 2013 at 4:39pm

    So I thought for one to have ovarian cancer you had to have ovaries which transgender males /females do not have. Or did I miss something?

    Report this comment

    gundylan  
  • mtsnj
    Posted on January 12, 2013 at 4:16pm

    How many times do they get….just a matter of time for that big quake to hit.

    Report this comment

    mtsnj  
  • RDavis49
    Posted on January 12, 2013 at 4:11pm

    I demand government paid for health care for my cat and dog too…

    Report this comment

    RDavis49  
  • SocialistSlayer
    Posted on January 12, 2013 at 3:48pm

    Disgusting !

    Report this comment

    SocialistSlayer  
  • 13th Imam
    Posted on January 12, 2013 at 3:48pm

    Pedophiles are next on the DEMOCRAT Freebies Constituency

    Report this comment

    13th Imam  
    • Keatonc33
      Posted on January 12, 2013 at 9:31pm

      haha i dont know.. democrats and catholics rarely see eye to eye

      Report this comment

      Keatonc33  
    • Inlightofthings
      Posted on January 13, 2013 at 7:30am

      KEATON tries to be funny…and fails. Catholics voted democratic to the tune of 60% +/- the last 2 elections.

      Report this comment

      Inlightofthings  
    • Rampart
      Posted on January 13, 2013 at 11:26pm

      Maybe once the Libertards mainstream pedophilia they’ll re-think their stance on abortion…

      Report this comment

      Rampart  
    • Rampart
      Posted on January 13, 2013 at 11:31pm

      Or more aptly stated, I wonder if they’ll rethink their stance on abortion…

      Report this comment

      Rampart  
  • barber2
    Posted on January 12, 2013 at 3:42pm

    Hey, this is just another one of those ” fundamental changes” that the Chicago radical Democrats are bringing to America ….

    Report this comment

    barber2  
  • civilwarcometh
    Posted on January 12, 2013 at 3:27pm

    I thought we were a nation of laws not a nation of rule’s and regulation’s. Stop paying taxes and paying these people’s salary’s to rule over us. If you keep paying your taxes to these IDIOT’S this will never stop. If you pay your taxes then you condone what they do to you. So just keep on paying and complaining. If your scared of the IRS then they have already WON! I don’t pay people to rule over me and i am NOT scared…

    Report this comment

    civilwarcometh  
    • barber2
      Posted on January 12, 2013 at 3:46pm

      “Civilwarcometh”….you must be one of those ” Let’s Have a Revolution” dudes I used to read comments by in the NYT back in 2008. Hmmmm….Are you the initial storm troops for the ” Big Changes” that the radical Obama Left is planning ?! Makes me wonder. I remember all of the ” neo-cons/ plutocrats/ anti-capitalism and anti-military comments. Where ARE you guys coming from ?? Anarchy ?

      Report this comment

      barber2  
    • jeffersonian1776
      Posted on January 12, 2013 at 4:09pm

      The transgendered dude or dudess said that he sees “everybody else being taken care of” so why can’t he too. Wait, I thought that the private healthcare system here was the most evil, oppressive, greedy capitalism-loving, system ever “forcefully” thrust upon a people in the history of the world? How the hell is everyone else being taken care of here but the he/shes among us? What a bunch of hypocrits these progressives be!
      Hell, let’s just get it over with and make every single thing equal for everybody. That includes forcing the NBA and NFL to accept short white fat girls. No one shall ever discriminate on grounds such as this ever again. I would much rather live in my decreasingly unequal and discriminating world than the one that these crackpots have planned for us all, anyday. An equal society IS NOT a free society based on individual liberty and private property! The two are diametric opposites of one another. These fools think they can legislate racism, sexism, and everything else. All that comes from it though is the destruction and plundering of YOUR valuable resources in the process.

      Always, always remember, that:

      Capital is not homogeneous!

      Report this comment

      jeffersonian1776  
    • civilwarcometh
      Posted on January 12, 2013 at 4:22pm

      BARBER I tried to respond to you but they didn’t let it go through but you are wrong about me. I don’t really care what you think of me…I’m 50 years old raised 3 girl’s with no one’s help. I have a body of a 65 year old I’ve worked my a$$ for years to give my kid’s what they need. I’m getting old and tired. I’m just done with ALL the commie BS…..Go give some lefty troll some BS…

      Report this comment

      civilwarcometh  
    • Anonymous T. Irrelevant
      Posted on January 12, 2013 at 4:34pm

      The procedure is strictly cosmetic. I have NEVER heard of health insurance paying for a procedure that is strictly cosmetic. Mental reasons aren’t enough to justify the expense.

      Report this comment

      Anonymous T. Irrelevant  
    • barber2
      Posted on January 12, 2013 at 6:08pm

      CIVIL : if you aren’t a Troll, I share your disgust with the Far Left Chicago radicals. I am just alarmed at what I see as the Left’s attempts to both divide conservative voters to weaken conservatives in the nest election / House ( witness the Trolls who post here ) and with what just might be the enticement to violence that these Trolls can use. ( I think that the radical Obama Democrats were involved in enticement in that Muhammad video which they planned as a cover for the Benghazi/ 911 riots – since the Democrats were boasting in October at their convention that ” GM was alive and Bin Ladin was dead.” ) I think the Democrats would love to entice people to start a ” revolution” so that the White House could declare Martial Law and lock up all political opposition. I do NOT trust these radical Democrats any more than I trusted the Soviet Communists. They all share the same dedicated hatred and desire to destroy American capitalism. The Democrats use the PC code word ” change.”

      Report this comment

      barber2  
    • civilwarcometh
      Posted on January 13, 2013 at 12:55am

      BARBER: I watched Glenn everyday since he was on CNN. Can’t afford the blaze T.V. I know about the chicago radicals. Glenn has awaken a lot of good people. So let’s fight the bad guy’s and not each other. We all don’t agree on everything. But our freedom and our right’s we should stand together on.

      Report this comment

      civilwarcometh  
  • john vincent
    Posted on January 12, 2013 at 3:23pm

    Transgender??

    Far too kind a word. How about transvestite??

    Public opinion is shifting toward tolerance? Right, the same way the men of Sodom and the cities of the plain were your average citizen

    If public opinion is allegedly leaning toward ‘these decent’ souls, then it is further proof of the erosion of morality, where everyman does what is right in his own eyes, Without the level bubble of a God given conscious, decadence will wax worse and worse.

    And any one who is not on board with this ‘improved understanding’ will be marked as slow of thought, maybe even retarded. (no offense to these folks) Transgender?? Yes, an apple is an orange; the light switch is off even while it is on; snow is the same as fog; pork is the same as peanut butter; left is right, and right is wrong; these folks are just a few doughnuts short of a dozen.

    Report this comment

    john vincent  
    • Metallicat
      Posted on January 12, 2013 at 3:38pm

      it seems the MSM tells us what we want more and more each day,without a public vote on the topic at hand. they use the fact that since Obama won the election,the vast majority of America supports the extremist views of the left.

      Report this comment

      Metallicat  
    • john vincent
      Posted on January 12, 2013 at 4:02pm

      metal-
      yea, almost like a psycological warfare…these people are clever in their stupidity- they float ideas to make their ideas palatable. ie, Lance Armstrong will make an announcement on Oprah as to his shortcomings. Kind of appears he already made the announcement. Same thing with Presidential speeches: CNN, Fox, etc tell you ahead of time what the speech will be. They know how to soften the blow, and PREPARE folks…

      But this monster of transgender (yuck) has gained traction over time; would not have worked 30 years ago, but lo and behold, its now coffee table talk. Not sure if there is hope for this country.

      Report this comment

      john vincent  
    • RDavis49
      Posted on January 12, 2013 at 4:17pm

      How about perverted, mind warped, insecure moron trashy people…..

      Report this comment

      RDavis49  
    • Verceofreason
      Posted on January 12, 2013 at 4:19pm

      Tranvestites and transgender are two different things

      Report this comment

      Verceofreason  
    • The-Monk
      Posted on January 12, 2013 at 4:45pm

      @Verceofreason

      Dang, what happened Dora/Charles? You’re back to this old account?

      Report this comment

      The-Monk  
    • john vincent
      Posted on January 12, 2013 at 5:14pm

      verce-
      98% of people know that, but hey are equally bad news, most readers got the point

      Report this comment

      john vincent  
    • barber2
      Posted on January 12, 2013 at 5:57pm

      MONK: Speaking of transgendered, DORA / CHARLES 116 / VERCE … are experts on all of that . Might be tri-gendered ?

      Report this comment

      barber2  
    • randy
      Posted on January 12, 2013 at 6:58pm

      Tranvestites and transgender are two different things

      NO they’re not. They’re both freaks!

      Report this comment

      randy  
    • Walkabout
      Posted on January 12, 2013 at 9:13pm

      Verceofreason
      Tranvestites and transgender are two different things
      ***
      I don’t thinks so. I bet there is overlap. It might not be 100%, but there is significant overlap.

      Report this comment

      Walkabout  
    • DZ-015
      Posted on January 14, 2013 at 10:15am

      Verce: Having some identity issues of your own? It looks like you scraped the face off your Miracle Toast avatar.

      Report this comment

      DZ-015  
  • DZ-015
    Posted on January 12, 2013 at 3:17pm

    No preexisting conditions in Obamacare plus the $700,000 it costs for gender reassignment surgery (from the story of the MA prison inmate) means private insurance companies will be out of business even quicker, so the goal of single payer rationed healthcare is attained sooner.

    Report this comment

    DZ-015  
  • Shasta
    Posted on January 12, 2013 at 3:16pm

    And everyone in Cal will see their premiums go up again due to this perversion. Most states that are run by liberals are burdened with tremendous debt. Federal bailouts for states and cities run by these imbiciles (democrats) is right around the corner.

    Report this comment

    Shasta  
    • booger71
      Posted on January 12, 2013 at 4:49pm

      When Obama finally gets single payer forced through, it will be nation wide

      Report this comment

      booger71  
  • stopprintn
    Posted on January 12, 2013 at 3:12pm

    They should just ban sanity in Calfornia and Oregon. Just get it over and done.

    Report this comment

    stopprintn  
  • diskinetic
    Posted on January 12, 2013 at 3:12pm

    So, are tattoos, piercings, haircuts, etc. covered?

    Report this comment

    diskinetic  
  • Metallicat
    Posted on January 12, 2013 at 3:08pm

    what stupidity. they want to play mad scientists with mother nature,and be insured when they do it,and things dont go right. its like a pyromaniac demanding fire insurance.

    Report this comment

    Metallicat  
  • TheEndIsComing
    Posted on January 12, 2013 at 3:06pm

    The genetic code of these people cannot ever be reassigned. Men are men and women are women. X’s and Y’s cannot change. It doesn’t matter what is cut off or pasted on, God will never be mocked. What these people need is to get their head fixed, not heir body.

    Report this comment

    TheEndIsComing  
  • dosdelgados
    Posted on January 12, 2013 at 3:04pm

    ” A person who identifies as a man might be denied coverage for ovarian cancer screening or a hysterectomy. A transgender woman might be denied a prostate screening.”

    Men don’t have ovaries. If you have ovaries, you are a woman. The end.

    Report this comment

    dosdelgados  
  • right-wing-waco
    Posted on January 12, 2013 at 3:01pm

    I do not discriminate & I really do not care what others do… but I am also a believer in the Bible. I fear we have returned to the reasons that God destroyed Sodom.

    Report this comment

    right-wing-waco  
    • RDavis49
      Posted on January 12, 2013 at 4:24pm

      I do believe you have a good point there. Seems all the modern day sins (plus some) were mentioned as being practiced in sodom just before God’s wrath struck…..Gonna be a hot time in the old town tonight when it happens too.

      Report this comment

      RDavis49  
  • Eastinfection
    Posted on January 12, 2013 at 2:59pm

    Never trust any girl in California or Oregon wearing turtleneck.

    Report this comment

    Eastinfection  
  • WildschweinJager
    Posted on January 12, 2013 at 2:52pm

    Never, ever go to California or Oregon for any reason, ever.

    Report this comment

    WildschweinJager  
    • powedj
      Posted on January 12, 2013 at 6:19pm

      @WILDSCHWEINJAGER

      You should add Washington to your never ever list. Oh dang, I live in Washington.

      Report this comment

      powedj  
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