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Insurance Commissioner makes Pennsylvania 17th state to release guidance prohibiting discrimination against gender identity

Harrisburg—Earlier this week Pennsylvania’s Insurance Commissioner Teresa Miller released guidance prohibiting discrimination by health insurance companies on the basis of gender identity. Notice 2016-05 explicitly prohibits private health insurance plans regulated by the Pennsylvania Insurance Department from denying coverage for medically necessary health care for transgender Pennsylvanians.

Notice 2016-05 specifically states that state-regulated private health insurance “will not contain a categorical exclusion of coverage for all health services related to gender transition” and “will affirmatively provide that medically necessary covered services will be available to a policyholder regardless of their gender identity.” In addition, all policies will have to include a prominent notice that informs Pennsylvanians about these new nondiscrimination protections.

In prohibiting discrimination against transgender Pennsylvanians, the guidance cites state nondiscrimination laws, such as the Pennsylvania Unfair Insurance Practices Act, and a proposed rule under the Section 1557 of the Affordable Care Act that is expected to prohibit transgender exclusions. These protections apply broadly to private health insurance for individuals and families, small employers, and large employers whose coverage is regulated by the Pennsylvania Insurance Department.

Ted Martin, Executive Director of Equality PA said this today: “It’s a tremendous act of support from Commissioner Miller to release this guidance, and Governor Wolf’s continued support for LGBT people is putting Pennsylvania on the map. As an organization committed to nondiscrimination and LGBT health equity, ending harmful transgender exclusions has been a significant priority, and we are grateful to the Wolf Administration for taking concrete steps to address the needs of some of the most vulnerable members of our community.”

Drea Baldini is a small business owner and transgender woman who lives in Philadelphia. “I’m so grateful towards Pennsylvania Insurance Commissioner Teresa Miller, as well as for Governor Wolf for their work to address health disparities for people like me. As a transgender woman, knowing that I can receive equal and inclusive health coverage is essential to knowing I will be healthy well into the future.”

Notice 2016-05 continues significant momentum to end transgender exclusions at all levels of government and within the private sector. With the issuance of this guidance, Pennsylvania has become the 17th state (plus DC) to ban transgender exclusions. Notice 2016-05 also follows a recent decision to lift Medicare’s previous ban on covering transgender-inclusive health care as well as a recent proposed rule from the U.S. Department of Health and Human Services that, once finalized, is expected to prohibit most transgender exclusions nationwide.

The private sector is also leading the way in ensuring that employees have access to affirming health care: 40 percent of all Fortune 500 businesses now offer transgender-inclusive health coverage, and major companies headquartered in Pennsylvania—including Aramark, Comcast NBC Universal, Erie Insurance Group, and Hershey as well as the state employee health plan—have transgender-inclusive health insurance policies.

With these changes, policymakers such as Commissioner Miller and Governor Wolf recognize that equal access to health care for transgender people is good public policy. Ample evidence shows that the removal of transgender exclusions results in improved health outcomes for transgender people and does not impose significant costs.

Transgender Pennsylvanians who face any challenges in accessing care should contact the Pennsylvania Insurance Department to file a complaint or contact EQPA.

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With 60,000 members across the commonwealth, Equality Pennsylvania is the leading organization advancing equality and opportunity for lesbian, gay, bisexual, and transgender Pennsylvanians.
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