Eight States Now Coming for Adult Trans Health Care, Too

[Carolyn Marie]

https://abc7ny.com/post/what-is-transgender-care-arizona-georgia-idaho-kentucky-mississippi-oklahoma-texas-virginia-move-restrict-adult/15905613/

 

 

Of course we have always known it was a lie that the R's "Just want to protect the children."  They want to eliminate all public funding or subsidies for adult trans health care, too.  They won't stop there, either:  once they eliminate Medicaid, they will put a stop to all trans health care, even that funded by private insurance or cash.  They want to eliminate us.  Period.

 

Carolyn Marie

[VickySGV]

To me these are simply copy-cat crimes of the DC crowd. By now insurance carriers know that effective care for us is money saved in claim settlements that can go into shareholder pockets.  I had a couple of cases I worked where I had to deal with folks at our State Dept. Of Insurance and while I was not out to myself back then, I do remember discussion of stats they were developing on our care vs hard nose denials of insurance. 

 

I am still waiting to watch the looks of chagrin when some of these folks realize they have just cut off drugs and procedures that are indeed a vanity item for themselves. 

[Ivy]

2 hours ago, Carolyn Marie said:

They want to eliminate us.  Period.

Exactly

[Charlize]

The attacks continue.  We are such an easy target. 

 

Hugs,

 

Charlize

[Davie]

Some people stand up for health care.

[awkward-yet-sweet]

Restrictions on using government funds.  That's it.  It is not some sort of total ban, not even close.  They aren't trying to tell us what we can't do with our own money...just what we can't do with Other People's money.  Those are very different things.  

 

America needs to decide what these government health programs are for.  Anything and everything? Essentials only?  And if so, what is the definition of that?  Who decides?  What kinds (or all) of gender-affirming care qualify?  

 

Approaching the issue randomly, as a sudden reaction, or piecemeal is the major issue I see here.  

 

[MaeBe]

So we get to play slippery slope politics now. The fact remains that the same treatments are covered for cis people while they’re stripped from trans people. Because a person is trans they don’t get access to care via Medicaid/Medicare? Do trans people not deserve care? Why is Aunt Martha’s hip replacement covered, she’s not liable to be very productive as a member of society but she gets her hip. A young trans person that has nothing but potential is abandoned? They have to pay out of pocket, somehow, to exist?

 

Maybe if the system were different it might not be an issue, but the system remains and cis people are benefiting in full regard. Cis women get their E, cis men get their T and ED pills, and precocious puberty will be treated by blockers available to cis youth. So, it seems there is a problem with the argument. Unless cis people deserve care when trans people do not?

 

Of course the answer is, “tear it all down!” Baby out with the bathwater! With the glint of the world burning in the eyes and a smile on the face. 

 

 

 

[Ivy]

2 hours ago, MaeBe said:

Unless cis people deserve care when trans people do not?

This.  

This exposes the reality that these laws are simply aimed at trans people.  Apparently there's no problem with the actual treatments, it's just who is allowed to get them.

There are a lot of things that I'm not happy about how the government spends my tax money.  (And despite being a "parasite" I actually do pay taxes unlike some billionaires)  Let's be honest, these laws are targeted at trans people.  They have said (in so many words) that they are working for our eradication.

[KatieSC]

Well, this will not stop at 8 states. There are 25 legislatures controlled by the R party. You have to hand it to them. They plotted and planned on how to unite themselves across the country in a blitzkrieg style attack, and we are catching the brunt as we are an easy target to polarize these states. The problem is that the Ds are running scared. With the current state of fracture within the D party, they have no idea on how to respond. What they fail to realize is that they have no unified message to win back the masses, and they are trying to rely on lying low. People crave strong leadership regardless of whether it is always right. We saw how this played out during the election. 

 

I suspect things will get more difficult before they get better. Hopefully, there will be a realization that the hate they are dumping on us is nothing short of vindictive and unwarranted. Unfortunately, we are facing a tsunami of vitriol. 

[awkward-yet-sweet]

18 hours ago, MaeBe said:

The fact remains that the same treatments are covered for cis people while they’re stripped from trans people. Because a person is trans they don’t get access to care via Medicaid/Medicare? Do trans people not deserve care? Why is Aunt Martha’s hip replacement covered, she’s not liable to be very productive as a member of society but she gets her hip. A young trans person that has nothing but potential is abandoned? They have to pay out of pocket, somehow, to exist?

 

 

Lots of folks understand that Medicare/Medicaid is basically bottom-of-the-barrel.  VA isn't great either. Both of my husband's parents were military, and his mother was a VA doctor later.  Both of them carry private insurance because they can get better care that way.  They can't and don't count on government programs, because getting care is a difficult process.

 

So, I'm not sure the argument that everything is easy for cis folks is accurate.  Cis people have issues with access as well, especially for stuff that isn't totally physical.  Coverage for mental/behavioral health is a massive problem.  If you need SSRI medication, getting it can be tough and getting repeated necessary adjustments and evaluation is even tougher.  Need counseling?  Good luck getting that covered.  Medicare will challenge every single step you take.

 

The mental health issue is very relevant to whether people receive gender-affirming care.  How is it classified?  Medical insurance and government programs are extremely dependent on classification.  Being trans isn't always exactly a physical problem.  Lots of trans folks have perfectly functioning original bodies - they just don't feel like they fit in those bodies.  A trans person's existing physical body usually continues to live and function just fine without gender-affirming care.  So, according to the system, that puts it more in the mental/behavioral health category.  And as I mentioned before, mental/behavioral health is notoriously difficult care to receive for anybody in systems funded by the taxpayers.  A cis female gets estrogen to fix a physical problem.  But when a trans female needs estrogen, the system doesn't see it as a physical thing. 

 

This goes beyond any sort of prejudice, its a problem of the system and how aspects of care are billed and coded.  If the system is to remain, then voters and officeholders have to answer some basic questions about why the government has medical programs, and what the goals and boundaries of those programs should be.   

 

 

[Ivy]

It can be frustratingly slow together care at the VA, but at least it's possible to get it - or has been.

TBH, from what I've heard, the particular VA hospital I go to is better than some others.

But I do expect trans care to disappear.

[MaeBe]

5 hours ago, awkward-yet-sweet said:

Both of them carry private insurance because they can get better care that way. 

I am happy they can afford care.

 

5 hours ago, awkward-yet-sweet said:

I'm not sure the argument that everything is easy for cis folks is accurate

I didn’t say it was easy, but they have access. Stop twisting words. 

 

5 hours ago, awkward-yet-sweet said:

And as I mentioned before, mental/behavioral health is notoriously difficult care to receive for anybody in systems funded by the taxpayers.

I have direct experience with Medicaid, this isn’t the case at all. My children have had access to care, in fact it covered an intensive therapy option that I was very worried wouldn’t be covered.

 

Perhaps Medicare is different for different populations in different locations. It’s definitely not getting any better under Trump (or “better defined”).

 

5 hours ago, awkward-yet-sweet said:

A cis female gets estrogen to fix a physical problem. 

Menopause is a normal function of the body. Of the women I know that are taking HRT for peri/menopause is for the mental issues they experience.

 

5 hours ago, awkward-yet-sweet said:

This goes beyond any sort of prejudice, its a problem of the system and how aspects of care are billed and coded.  If the system is to remain, then voters and officeholders have to answer some basic questions about why the government has medical programs, and what the goals and boundaries of those programs should be.

I think you’re arguing in bad faith, that your perspective is that there should be no government assistance. So you frame the care it provides as bad, the existence of the systems as tenuous (though they have long existed—and the reason for them plain), argue that privileged people choose private insurance over public options, etc. to create a negative narrative about programs that help many Americans.

 

The argument is: cis people have access to gender affirming care, but transgender people do not. It’s not a billing code issue. It is a bias issue. Certain people think and have convinced others that trans people aren’t human or valid and don’t deserve to exist.

[Ivy]

3 hours ago, MaeBe said:

Perhaps Medicare is different for different populations in different locations. It’s definitely not getting any better under Trump (or “better defined”).

Basic medicare doesn't cover much but hospitals.  Part B covers more, but you have to pay for it.  The "advantage" plans are a bit of a scam.

Medicaid does vary by state.

 

I get care from the VA, but there are Republicans that would like to privatize that.  I don't see how a private middle man making a profit would make it better though.  It remains to be seen if there is any VA left after the DOGE boys are done with it.

[VickySGV]

Just now, Ivy said:

 The "advantage" plans are a bit of a scam.

I have the OASDI Medicare through the "Advantage" system that copy cats the plan I have with my State Employers plan which was also administered by my Public Employee's Retirement System and since my state is bright blue and the retirement system owned by the participating employees so our Advantage Medicare is about the best you can get, and if we do not have the SS stuff could still bear with us.  One rather reddish legislature 20 years ago tried messing with our retirement system and ended up paying about 120% of what they would have if they left it alone. The goof was an instrument in changing the color 4 years later.

[awkward-yet-sweet]

10 hours ago, MaeBe said:

I didn’t say it was easy, but they have access. Stop twisting words.

My point is that not everybody has access.  Folks who do have access have to fight for it and be persistent.  Sometimes successfully, sometimes not.  Good service, complete service, or any service at all... these things are definitely not guaranteed using public options, and can even be difficult to deal with using private options.

 

10 hours ago, MaeBe said:

I have direct experience with Medicaid, this isn’t the case at all. My children have had access to care, in fact it covered an intensive therapy option that I was very worried wouldn’t be covered.

 

Perhaps Medicare is different for different populations in different locations. It’s definitely not getting any better under Trump (or “better defined”).

You make a valid point.  Location makes the Medicare/Medicaid experience very different.  We don't have a plethora of options in my area, and older folks trying to get Medicare to cover stuff, especially therapy...its a nightmare.  Folks often pay out of pocket to avoid the hassle, to save time, and bypass denials. 

 

10 hours ago, MaeBe said:

I think you’re arguing in bad faith, that your perspective is that there should be no government assistance. So you frame the care it provides as bad, the existence of the systems as tenuous (though they have long existed—and the reason for them plain), argue that privileged people choose private insurance over public options, etc. to create a negative narrative about programs that help many Americans.

 

The argument is: cis people have access to gender affirming care, but transgender people do not. It’s not a billing code issue. It is a bias issue. Certain people think and have convinced others that trans people aren’t human or valid and don’t deserve to exist.

 

IDK how you can make it personal, calling it bad faith.  It is an unfair and impolite assumption, and I'd prefer not to get into that sort of thing.  I think we've firmly established that we don't agree on much beyond the color of an orange.  That's OK, and even interesting. 

 

I believe it is erroneous and excessively optimistic to claim we have a good, working system.  The majority of Americans loathe how healthcare is run.  (Surveys seem to run as high as 70-80%, for what that's worth)  Actually, that feeling is bipartisan...folks just disagree on how it could be improved.  Some folks want more government involvement, some folks want less.  I would prefer practically none at all....I've never hidden my opinion on this.  Of course I'm anti-government, and I would be pleased if government "assistance" was withdrawn because I believe that the various programs, along with the bloated insurance industry, have over decades caused the high prices everybody faces today.  The "prize" isn't worth the pain.  I believe all of us would have more choices if American society used a different path.  

 

So yeah, care is often poor.  The existence of the system is tenuous, and folks are particularly under-served when it comes to mental/behavioral health.  And that gap specifically affects LGBTQ+ folks because of how gender-affirming care is defined.  My husband's mother is a local official - county coroner and director of the county medical clinic.  My friend (who happens to be trans) is a nurse at that clinic, formerly working at the large hospital in the next county.  I've heard plenty of Medicare and insurance billing stories, and stories about the difficulty of referring patients to mental health providers.  It is probably the biggest issue in US healthcare these days. 

 

20 hours ago, awkward-yet-sweet said:

If the system is to remain, then voters and officeholders have to answer some basic questions about why the government has medical programs, and what the goals and boundaries of those programs should be.  

^^^ Regardless of my personal beliefs, the USA has reached (and perhaps passed) the moment when these clarifying questions have to be asked.  

 

So no, I don't see it as a bias issue.  And even where bias exists, it isn't the only factor in people's bad experiences with healthcare.  I absolutely reject the "privilege" stuff that is so popular in our politics today.  I do not see removal of public options as a major threat or as as positive proof of bias, because of the surrounding issues I have described. 

 

None of that prevents bias and hatred from becoming an issue in the future.  It is certainly possible that laws could be proposed restricting gender affirming care or banning it entirely in any system regardless of payment method. If that happens, I believe that would be not only a violation of personal rights and bodily autonomy, but also a violation of our ability to conduct commerce.  Hopefully a move like that would face broad opposition from across the political spectrum.