The federal Department of Health and Human Services announced Thursday that it will reconsider a longstanding denial of gender-confirming surgeries for transgender people on federally subsidized healthcare.
Since 1989, both Medicare and Medicaid, the federally-run health program for low-income families and individuals, have explicitly excluded the coverage of gender confirmation surgeries for transgender individuals, reports The Advocate
“Under National Coverage Determination 140.3, the programs have been exempted from covering these surgeries, though the data cited in the government’s justification is based on a 1981 National Center for Health Care Technology report. “Because of the lack of well controlled, long term studies of the safety and effectiveness of the surgical procedures and attendant therapies for transsexuals, the treatment is considered experimental,” reads the report in its explanation for why such procedures are not covered by insurance. “Moreover, there is a high rate of serious complications for these surgical procedures. For these reasons, transsexual surgery is not covered.”
“A lot has changed since 1981, however. The American Medical Association and American Psychological Association have since issued statements in support of gender-confirmation surgeries as a medical necessity and acceptable treatment for those suffering from gender dysphoria.
“In a ruling released December 2, the Department of Health and Human Services Departmental Appeals Board declared that the current National Coverage Determination record “is not complete and adequate to support the validity” of the determination excluding coverage for gender-confirming surgeries. The board determined that the 1981 report, which reviewed medical and scientific sources published between 1966 and 1980, is no longer “reasonable in light of subsequent developments.” Continue reading “Medicare reconsiders surgery rules”