Insurers in New York Must Cover Gender Reassignment Surgery, Cuomo who the "Orthodox" Jewish community just voted for Says
Lee Albertorio felt like a man trapped in a woman’s body. After serving in the Air Force,
she began taking hormones, which deepened h
eris voice and made h
eris physique more masculine.
SHe changed h
eris passport to reflect that h
eris was
posing as a male, and last year
she decided to have a mastectomy, known as top surgery. But h
eris insurance company told h
eris the operation was cosmetic and refused to cover it,
she said Wednesday.
Now Gov. Andrew M. Cuomo
YMS who won the "Orthodox" Jewish vote in almost every single Jewish ED is warning insurance companies that they will no longer be allowed to deny gender reassignment surgery or other treatment to change a person’s gender, like hormone therapy, if a doctor has deemed that treatment "medically necessary".
In a letter being sent to insurance companies this week, the governor said that because state law requires insurance coverage for the diagnosis and treatment of psychological disorders, people who are found to have a
psychological mismatch between their birth sex and their internal sense of gender are entitled to
expensive insurance coverage for treatments related to that condition, called gender dysphoria.
making everyone else's premiums rise significantly
“An issuer of a policy that includes coverage for mental health conditions may not exclude coverage for the diagnosis and treatment of gender dysphoria,” the governor’s letter says.
“That would change everything — I mean that sounds very good,” Mr
s. Albertorio said excitedly when told of the governor’s order.
The rule makes New York the ninth state to require the coverage, the Transgender Legal Defense and Education Fund, an advocacy group, said on Wednesday. The others are California, Colorado, Connecticut, Illinois, Massachusetts, Oregon, Vermont and Washington, according to the group. Washington, D.C., also mandates it.
The group said that most insurance policies currently exclude coverage for transgender treatment, and at best include it as a more expensive rider to a standard plan.
“This is an absolute sea change in the way that insurance for transgender people will cover their health care needs,” Michael Silverman, executive director of the fund, said. “This essentially opens up an entire world of treatment for transgender people that was closed to them previously.”
Leslie Moran, a spokeswoman for the New York Health Plan Association, the trade association for most health plans across New York State, said the industry did not object to having to cover gender dysphoria.
But she said the industry was concerned that the governor’s order could
raise costs in the new year that are going to be transferred over to you that were not contemplated during the recent round of rate-setting. And she said companies were concerned that the policy would open the door for other services that people might seek, claiming they were medically necessary for mental health reasons.
“It sets a precedent,” Ms. Moran said.
Benjamin M. Lawsky, the state’s superintendent of financial services, which regulates insurance, said he would “be very surprised” if the change led to a
noticeable after all an extra few dollars a month is not that noticeable and "doesn't" add up rise in insurance premiums, because the number of transgender people would be such a small part of the insurance pool.
“It will further solidify the rights of a group that probably weren’t always being treated as equal to everybody else, and that’s sort of fundamental to our system,” Mr. Lawsky said.
The new policy comes as the state is trying to negotiate a settlement in a
class-action lawsuit seeking Medicaid coverage for sex-change treatments, and advocates said they hoped it was a signal that the state was going to approve that coverage as well. Mr. Lawsky said that State Senator Brad Hoylman
YMS, a Manhattan Democrat, had brought the issue to his attention in June, by pointing out that several other states had barred insurance companies from excluding gender-change treatment.
At that time, a review board of the United States Department of Health and Human Services had just ruled that transgender people could no longer be automatically denied coverage for sex reassignment surgeries under Medicare, reversing a policy in place since 1981.
Mr. Hoylman said this week that he knew people who had had to scrape together money from fund-raisers to pay for their gender reassignment surgery. “Nobody should be in that position in order to embrace such a fundamental aspect of their personhood,” he said.
Mr. Hoylman said he was hoping the governor’s directive signaled that the political climate was right to pass a “transgender civil rights act” in the state, guaranteeing that transgender people would not suffer discrimination in other areas like housing
and forcing them into all Jewish Stores, and allowing men into women's bathrooms and the like.
Mr
s. Albertorio, 30, a program coordinator at a nonprofit agency, wanted the top surgery so badly that
she paid for it using $6,500 in loans and credit card payments. To complete h
eris transition will cost at least $50,000, which for h
eris is “pretty out of reach
and therefore is going to be transferred to you”.
(
NYT) highlight portions our additions
 |
| Letter that was sent out forcing theses changes |
Cuomo's official statement (highlighted portion is necessary additions)Department of Financial Services Notifies Insurance Industry That Medically Necessary Treatment For Gender Dysphoria Cannot be Denied
Governor Andrew M. Cuomo today announced that regulatory guidance has been issued to help ensure that transgender New Yorkers have equal access to commercial health insurance coverage. The Department of Financial Services (DFS) today sent industry guidance to all New York insurers stating that they may not deny medically necessary treatment for gender dysphoria – a condition when a person's gender at birth is contrary to the one with which they identify.
“Respecting the rights and dignity of all New Yorkers is paramount
unless your religious,” Governor Cuomo said. “By taking this action, we are ensuring that principle rightfully extends to transgender people across our state and
continuing New York’s legacy as a progressive leader for the nation. I urge other states to follow our example on this issue, because
"discriminating
" against people on the basis of their gender identity simply should not be tolerated.”
Benjamin M. Lawsky, Superintendent of Financial Services, said, “We hope this action sends a powerful message that
"discrimination
" against transgender people will not be tolerated. Transgender New Yorkers deserve the same access to
"essential" health care as every other New Yorker. We especially thank Senator Brad Hoylman for working with us on this matter and for his steadfast leadership on LGBT rights
and assisted murder.”
Senator Brad Hoylman said, “I commend Governor Cuomo and Superintendent Lawsky for ending
"discrimination
" in health insurance in New York based on gender identity or expression. Moving forward, health insurance providers must cover treatments related to gender transition, which is regarded as medically necessary by leading professional medical organizations for many transgender people. Today’s announcement is
"important
" to the health and well-being of transgender New Yorkers and I’m honored to have worked with them on this
"important
" issue.”
Alphonso David, Deputy Secretary and Counsel for Civil Rights said, “The regulatory guidance issued by the Department of Financial Service today is yet
another step forward towards the never ending progressive goal of a progressive utopia by Governor Cuomo and the administration to remove long-standing, systemic barriers to
"equality
". The guidance will help ensure that transgender New Yorkers have
"equal
" access to coverage in the private marketplace. The Governor is committed to, consistent with law, continuing efforts to modernize New York State’s policies and practices to guarantee
"fair
" treatment for all New Yorkers
by making us all pay to humor someone's insanity.”
An insurer retains the right to review gender dysphoria treatment for medical necessity purposes, as it may do with any benefit covered under a health insurance policy. But, as with any covered benefit, any such review in a gender dysphoria treatment case must be performed with the full range of appeal rights set forth in Article 49 of both the Insurance Law and the Public Health Law.
A consumer whose gender dysphoria treatment has been denied has the right to file an internal appeal of the denial with the insurer. Information on filing an internal appeal is provided on the notice of the denial that an insurer is required to provide to the consumer. If an insurer denies the treatment on internal appeal, the consumer has the right to file an external appeal with an independent external appeal agent who will make their own medical necessity determination. Information on filing an external appeal can be found here.
