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@NCCapitol

State Health Plan to start covering sex-change treatments

Posted December 8, 2016

— The State Health Plan will start covering sex-change surgery and hormone therapy next year to meet federal regulations, but not everyone is happy about it.

Under the Affordable Care Act, "coverage exclusions or limitations for all health services related to gender transition are discriminatory." So, the board that oversees the State Health Plan voted last week to change the plan's rules to comply with the ACA rules.

Failure to comply with the regulations by not adding the coverage could have resulted in penalties, officials said.

The changes, which cover only treatments deemed medically necessary, take effect Jan. 1. The State Treasurer's Office, which administers the health plan, estimates the added coverage will cost $350,000 to $850,000 a year, which they said is equal to a premium increase of less than 1 percent.

"This is a welcome change to bring our state employee health plan into the 21st century," LGBT advocacy group Equality North Carolina said in a statement.

The North Carolina Family Policy Council is opposed to the new coverage.

"This is yet another consequence of the Obama Administration's reinterpretation of the word 'sex' to include 'gender identity,'" the group said in a statement.

The same interpretation is at the heart of a federal lawsuit against North Carolina over House Bill 2. The U.S. Department of Justice has accused the state of discriminating against transgender people by forcing them to use public bathrooms that correspond to the gender listed on their birth certificates.

State officials allow people who have undergone sex changes to have their birth certificates amended to reflect their new gender.

The State Health Plan provides coverage for more than 600,000 state workers, teachers and retirees and their dependents.

11 Comments

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  • Ron Coleman Dec 12, 12:25 p.m.
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    You don't seem to be informed enough to make a comment. State employees only pay a small portion of their health plan, the state pays the rest. A women going through menopause that needs hormone therapy does not just elect to do so she needs to do it. The logic you use is not logic, it is idiocy. Keep voting for Clinton someday you might figure it out.

  • Jacob Young Dec 11, 10:15 a.m.
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    You need to look up the definition of an insurance premium. The amount the employee pays is a small fraction of any services provided to the insured during the coverage period even if the claims are just for routine doctor visits and lab work. If a person undergoes a gender re-assignment procedure that entails surgeries, counseling, hormone therapies and who knows what else. To cover those expenses the employee would have to pay a premium several times their yearly salary.

  • Norman Lewis Dec 9, 2:59 p.m.
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    I am wondering if the "treatments" will include breast implants and subsequent upgrades for the male to female surgeries. How about male "enhancements" for the female to male surgeries? The term "treatments" could be stretched to include buying new clothes for the new identity, maybe even an apartment or house exchange if the neighbors can't adjust to the change in gender. Where will it end? I expect my premiums to skyrocket to pay for the new round of social experimentation. This is purely an elective type surgery and should NOT be paid for by the state employees premiums. I bet the reassignment doctors are already salivating over the boom in business coming their way.

  • Anna Temple Dec 9, 11:05 a.m.
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    I hope this does not affect that stomach surgery for people that will not control their eating. My sister needs that and it is expensive. I think everyone that wants to slim down should have this option. Makes everyone feel better plus easier to look at while eating. Wonderful procedure

  • Holly Atkins Dec 9, 10:09 a.m.
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    I was a state employee for quite a few years and in HR. The premiums that are paid, as noted in the article, will amount to a 1% increase. Every year state employees see their paid side increase and that is where that 1% will come from. So no, I'm not wrong. The state doesn't fully subsidize premiums and they certainly pass a ton of the premium on to the employee when it comes to family coverage, employee + Child, etc. What does that mean? It means Andy won't be paying for any of it!

    And if you're going to rule out hormone therapy for transgender then rule it out for EVERYONE! Menopause, peri-menopausal women those that take Viagra and others for ED, etc.

    Just because you may not agree with transgender rights doesn't mean you can discriminate against them.

  • Heather Bank Dec 9, 9:21 a.m.
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    NO you are wrong. The state pays along with the employee. We should not pay for something that does not treat a real medical condition and is completely unnecessary. The plan is funded by the state. Please do research before spreading misinformation.

  • Holly Atkins Dec 9, 8:56 a.m.
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    UUUMMMMM NO!! First off, the EMPLOYEES are paying the premiums so you don't have to worry about it coming out of your pocket.

    The hormone therapy for transgender MIGHT be voluntary but lest we forget so are other treatments that are covered. Women going through menopause go through voluntary treatment for the symptoms. The hormone therapy is NOT required...it's a means to make the process better. The coverage of ED drugs is VOLUNTARY but it's covered.

    Stop being so judgemental just because it isn't you; especially since you don't have to pay for it!

  • Buster Brown Dec 8, 10:23 p.m.
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    Transgender surgery is an elective procedure--not medically necessary--in fact gender identity disorder is a MENTAL problem not one that can be cured by surgery. So why are the taxpayers having to foot the bill for this??

  • Jacob Young Dec 8, 10:20 p.m.
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    "This is a welcome change to bring our state employee health plan into the 21st century," LGBT advocacy group Equality North Carolina said in a statement.

    It's more like going backwards. Gender identity disorder is a symptom of a disease. Treat the disease, not the symptom.

  • Byrd Ferguson Dec 8, 8:43 p.m.
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    Whoa- hold on. Who is paying for this? Another reason to dump Obama care. This reeks of liberalism.

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