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New state regulation forbids discrimination against trans individuals in health coverage

New state regulation forbids discrimination against trans individuals in health coverage

A new policy bulletin by the state’s top regulatory agency for health insurance guarantees that lesbian, gay and transgender Coloradans with health coverage receive equal treatment under their plans, promising access to dozens of services and procedures that were previously in doubt.

The Colorado Division of Insurance bulletin, posted today, interprets existing Colorado laws regarding health insurance and non-discrimination stating that discrimination in health coverage based on sexual orientation and transgender status is prohibited. That means that transgender Coloradoans cannot be charged more for health insurance, being trans cannot be considered a preexisting condition, and any procedure or treatment must be covered for transition-related care under an insurance plan that covers the same treatments for other conditions.

That can include things like hormone therapy, explained Brad Clark, executive director of statewide LGBT advocacy organization One Colorado, which helped push for the new clarification working with the Colorado Consumer Health Initiative. “There are a huge number of folks who get hormone therapy based on a diagnosis, and now that can’t be denied to trans people,” Clark said. “If you offer services or procedures to one group of people, you can’t deny them to trans people.”

The CCHI is a statewide coalition of many groups, including One Colorado, pushing to expand access to health care in the state.

“It’s our belief that these decisions should be made between a doctor and a patient and not an insurance company,” Clark said.

One Colorado has been working for years on a healthcare project to address concerns LGBT Coloradoans have in accessing health care, including their 2011 LGBT health care survey of 1,100 respondents in the state. “One of the biggest pieces of that is denial of care to transgender people,” Clark said. “This is probably one of the greatest health care policy victories we’ve seen in the short-term.”

Colorado is only the third state with this rule, joining a list that includes California and Washington D.C.

Announcing the changes today in an 11 a.m. newsletter to members, One Colorado added further examples of how the new rule could affect transgender individuals on an online Frequently Asked Question page:

If an insurer covers breast reduction surgery to lessen back pain, for example, that insurer could not deny breast reduction surgery for gender transition if the provider deemed the treatment medically necessary. If hormone therapy is covered for other policyholders, it cannot be denied for gender transition if determined to be medically necessary.

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