Pushing for Access to Health Care

[Carolyn Marie]

I work in local government, and this city has a very liberal council and mayor. Despite strong workplace protections for TG city workers, our health care plans exclude any coverage for treatment of GID, including therapy, HRT or surgery. To me, that is purely discriminatory, and flies in the face of the APA and AMA findings that GID is a recognized and treatable medical condition.

I've given some thought about how to fix this problem, and I believe the most effective way is through the contract negotiation process. So here is the message I sent to my union this morning:

Hello. I am inquiring about the process of changing the health benefits of the City's health plans to include coverage for transgender health issues. I am enrolled in the Anthem Blue Cross HMO plan. That plan contains language that specifically excludes any treatment for "sex change" or treatment for Gender Identity Disorder. GID is a medical condition recognized by the American Psychiatric Association and the American Medical Association. It has a specific treatment regimen, which includes hormone replacement therapy, and in some cases gender reassignment surgery.

There are so few openly transgender employees in the city, that adding coverage for treatment of GID would barely impact the cost of insurance for the city or its workforce. I'm guessing a few cents per year per enrolled employee. The only reason for excluding coverage for this condition is discrimination, based on prejudice against transgender persons.

State law now recognizes transgender persons as a protected group in all aspects of employment, education, and public accommodations. I am requesting the assistance of **** to bring this issue up during its next round of negotiations for contracts and health care benefits. I believe that there are several City Council Members who would be supportive of this, including Councilman ****** and Councilman ******.

Please respond to this request with an indication of whether **** will or will not ask for TG healthcare inclusion in its insurance coverage for city workers. I will not personally benefit from this request in any way, because I intend to retire in January 2013. My goal is to make life easier for other transgender city employees who come after me, and who should have equal access to health care.

Thank you very much

Carolyn M. ******

Progress is rarely made by waiting for someone else to do something. It's true that I outed myself, but its for a good cause. I'll let you know what, if anything, they say.

HUGS

Carolyn

[Carolyn Marie]

I received a quick, if somewhat cursory, response from the union: The JLMBC is the Joint Labor Management Benefits Committee.

A proposal to expand standard coverage to include GID may be presented at the JLMBC for discussion. The next City RFP for health care providers / health insurance companies will circulate in 2013.

The use of the word "may" instead of "will" is disappointing, but not unexpected. They will probably talk about this internally for a bit before deciding if its worth bothering with. It's better than a poke in the eye with a sharp stick, I suppose.

Carolyn Marie

[Guest LizMarie]

Good for you, Carolyn!

[Guest Mia J]

Good for you Carolyn. I hope they take it up.

Mia

[Guest MsPerseveres]

Well done!

Brenda

[Carolyn Marie]

Follow-up: Things have gotten more complicated. It seems that my type of insurance is regulated by a state agency, the Department of Managed Health Care. They are the ones who decide what conditions and diseases are covered by "fully insured" providers. That's a shame, because I have no doubt that a state bureaucracy is going to be far less sympathetic, and far harder to navigate, than a local one. What they ask one insurer to cover, they will likely have to ask all of them to cover. Such sweeping changes, especially to benefit a constituency as small and "fringe" as ours, isn't going to come easily.

But I've already sent a question to the DMHC, and we'll see how steep this mountain will be to climb. Anyone have a safety net?

Carolyn Marie

[Guest LaciGirl]

I saw this article the other day, and my apologies in advance if this is somewhere else on the forums...but think it pertains to the topic

http://www.buzzfeed.com/chrisgeidner/memo-obamacare-will-bar-discrimination-against-tr

I've been tyring to wrap my head around all of this healthcare stuff to see what options are available (or more likely...what steps I will have to take to make available) to have coverage for transition. Frankly its a bit beyond me, but it's something I'm trying to research & talk more intelligently about because I feel it's important.

So my question to you Carolyn...does this change anything with what you are trying to accomplish? Or does it not because of this being through a state agency???

[Carolyn Marie]

So my question to you Carolyn...does this change anything with what you are trying to accomplish? Or does it not because of this being through a state agency???

I think I saw the article somewhere, but not sure where. Thanks very much for posting it, Laci.

To answer your question, no it will not effect municipal employees, because our health care is not federally funded. It might help federal employees, if their health care providers currently exclude transition-related expenses. It might also help those who obtain insurance through a federally funded or subsidized "insurance exchange" that is part of the Obamacare legislation. On the other hand, as the article points out, the bill does not specifically mention coverage for transition expenses, just that it bars discrimination. What that means may be interpreted by each state or court differently.

It's a muddle, for sure. Those of us who choose to fight this battle will each fight it according to different rules, and with different opponents in every state.

Good luck to us all. The "mountain" awaits.

HUGS

Carolyn Marie

[KathrynJulia]

Hi Carolyn:

I'm entering the fray as well with the University of Missouri. They offer health insurance to the students that covers transition costs and surgeries. That being the case, I feel that our employee insurance should also cover the costs of GRS and transitioning as well. Seeing as the Vice Chancelor for Health Affairs is strongly pushing for equality and diversity, now might be the time to ask. Laci, thanks for posting that article. Does it apply to a state University that is covered under title 9 as well as Title 7 as we receive Federal Funding for Research, tuition, Medicare and Medicade funding only time will tell. So I'm going to give it my best try. Kathryn