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Oregon, California require transgender health coverage

Published: January 17. 2013 4:00AM PST

SALEM — Regulators in Oregon and California have quietly directed some health insurance companies to stop denying coverage for transgender patients because of their gender identity.

The new regulations apply to companies insuring about a third of Oregonians and about 7 percent of Californians.

The states aren’t requiring coverage of specific medical treatments. But they told some private insurance companies they must pay for a transgender person’s hormone therapy, breast reduction, cancer screening or any other procedure deemed medically necessary if they cover it for patients who aren’t transgender.

Advocacy groups said the action is a major step forward in their long battle to win better health care coverage for transgender Americans. The director of the Transgender Law Center in San Francisco says he’s unaware of insurance regulators in any other state taking similar action.

Officials in both states say the new regulations aren’t new policies but merely a clarification of anti-discrimination laws passed.

Many health insurance policies broadly exclude coverage of gender identity disorder or classify it as a pre-existing condition. Transgender patients are often denied coverage for medical procedures unrelated to a gender transition, advocacy groups said, because insurance companies deem the condition to be related to their sex reassignment.

— Jonathan J. Cooper, The Associated Press

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