December 8, 2017

Healthcare.gov Plans Better Than Ever for Transgenders

READ TIME: 2 MIN.

Out2Enroll released the results of an analysis of nearly 550 health insurance plans in 18 states showing that the vast majority of plans no longer include discriminatory transgender exclusions.

"This analysis confirms that health insurance options for transgender consumers continue to be better than ever -- despite the federal government's efforts to sabotage the Affordable Care Act and roll back protections for LGBTQ people," said Katie Keith, steering committee member of Out2Enroll. "In fact, even more insurers than last year are offering plans that confirm that medically necessary care for transgender people is covered, a best practice that we urge all insurers to adopt."

Out2Enroll's analysis included 548 silver marketplace plans from 71 insurers in 18 states that use HealthCare.gov. Key findings include:

  • For the second year in a row, the vast majority of insurers (90%) did not include transgender-specific exclusions in their marketplace plan options.

  • More insurers than ever before (28%) affirmatively stated that some or all medically necessary treatment for gender dysphoria is covered, an increase from 18.5% in 2017.

  • Fewer insurers (24%) had other types of exclusions-such as exclusions for certain procedures or overbroad "cosmetic" exclusions -- that would limit access to medically necessary treatment for gender dysphoria, down from 55.5% of insurers in 2017.

    "These findings, combined with the financial help that is available to many transgender people at HealthCare.gov, underscore the importance of this year's open enrollment period for the transgender community," said Harper Jean Tobin, Director of Policy at the National Center for Transgender Equality. "We urge all transgender people who need health insurance to visit HealthCare.gov before the final December 15th deadline to see if they qualify for financial help and to consider their options."

    To help transgender consumers better understand their options before the December 15th deadline, Out2Enroll released 18 state-specific transgender health insurance guides with information about plans being offered in Arizona, Florida, Georgia, Illinois, Louisiana, Michigan, Missouri, Nevada, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Virginia, West Virginia, and Wyoming. Out2Enroll urges all consumers to carefully review each plan to ensure it meets their needs or make an appointment with an LGBTQ-friendly expert who can help for free.

    Looking beyond open enrollment, the analysis also suggests that insurers acknowledge and understand that the gender identity nondiscrimination protections under Section 1557 of the Affordable Care Act remain in force and that discriminating against transgender people is bad business.

    In the coming weeks, Out2Enroll will continue working with an unprecedented nationwide coalition of over 60 national, state, and local LGBTQ and allied organizations committed to educating LGBTQ consumers about the health insurance options available under the Affordable Care Act until December 15th.

    Launched in September 2013, Out2Enroll is a national initiative focused on connecting LGBTQ consumers with insurance coverage options available under the Affordable Care Act.

    For more information, visit www.out2enroll.org

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