The State Department is eliminating transgender exclusions from the agency's largest health insurance program.
Insurance policies under the Federal Employees Health Benefits (FEHB) program general exclude services "related to sex reassignment."
In practice, this transgender exclusion “denies coverage to transgender people for the same treatments available to non-transgender policy holders, without regard to medical necessity,” the State Department said in a statement to the Federal Diary. “Insurance companies often view this exclusion in the broadest possible terms, excluding care that clearly has no relationship to gender status such as cancer treatment and routine preventive care.
Generally speaking, what insurance companies have done is consider any health concern of a person who is undergoing transition or has done so in the past as being "related to sex reassignment," resulting in transgender employees being just basically out of luck when it comes to obtaining coverage for just about anything.
Starting in January, such exclusion will no longer be part of the American Foreign Service Protective ssociation (AFSPA), which is the Department's largest insurance plan.
Because the exclusion in federal health-care coverage has been lifted, our daughter will have access to health care she needs like any other child of a federal employee. If the exclusion remained, we would pay out of pocket for her medical care even though we already pay for her to be included on my husband’s federal insurance.
--Kimi Kanda, Santa Clara, CA
State has about a dozen health insurance providers. All have been asked to eliminate the transgender exclusion. AFSPA is the first to do so. AFSPA covers more than 57,000 active and retired State Department employees and their families. The agency's second largest insurer is Blue Cross...that may be more problematic.
It’s about fairness and respect for our employees, but it’s also about showing the world we mean what we say and say what we mean. It’s tough to tell other countries to provide equal opportunity if we’re not living that out ourselves. So this matters in many ways. I’ve met transgendered colleagues at the Department and in addition to being brave and strong, they’re just good officers. Why should they have it any different when it comes to health care?
--Secretary of State John F. Kerry
Paula S. Jakub, AFSPA’s chief executive, said the association has “been working tirelessly” with the Office of Personnel Management (OPM) and others “for the last two years to make this benefit a reality.”
But it is not a reality for other plans in the OPM-administered FEHB program. OPM said it “removed its requirement that carriers exclude ‘services, drugs, or supplies related to sex transformations’ ” beginning in 2015, but it did not order health insurance companies to do so.
[OPM and SFSPA] are doing the right thing, ending this discrimination. All our colleagues deserve equal access to quality health care.
--Selime Ariturk, GLIFAA (formerly Gays and Lesbians in Foreign Affairs Agencies