Protecting Gender-Affirming Care Amid Policy Changes
In the early hours of his administration, President Donald Trump signed executive orders targeting gender diverse individuals, including an executive order condemning federal funds for gender-affirming care and redefining gender as binary. Though the order was blocked in court, and executive branch rescinded it, such actions represent a stark challenge to protection and support for one of the most vulnerable identified cohorts in the U.S.
For Medicaid MCOs, these developments raise critical concerns about the future of queer healthcare care and the role they must play in safeguarding access for gender diverse members and beneficiaries.
The Importance of Gender-Affirming Care
Gender-affirming care, which includes hormone therapy, surgeries, and mental health services, is essential for improving the health and well-being of gender diverse individuals. Research shows it reduces rates of depression, anxiety, and suicide while enhancing overall quality of life. For many gender diverse individuals, Medicaid is the only viable pathway to accessing this care.
Currently:
34 states and D.C. provide Medicaid coverage for gender-affirming hormone therapy.
25 states and D.C. cover gender-affirming surgeries.
However, this patchwork coverage leaves gaps in care, particularly in the 17 states with unclear policies and the 7 states with outright bans.
Protections Being Targeted
The Trump administration’s executive orders aim to undermine existing protections for gender diverse individuals by:
Declaring the federal government will recognize only two immutable sexes: male and female.
Prohibiting the use of federal funds for transition-related care.
While Medicaid policies are rooted in federal law and cannot be overridden by executive action, these orders may embolden states to restrict coverage, particularly in those with ambiguous policies. States with bans or unclear regulations could use this as justification to deny care, putting gender diverse individuals at risk of losing life-saving services.
The Role of Medicaid MCOs
In this challenging environment, MCOs have a critical role to play in protecting and advocating for gender-affirming care. Here’s what they can do:
1. Strengthen Provider Networks
Expand partnerships with providers experienced in gender-affirming care to ensure beneficiaries have access to competent and affirming services.
2. Advocate for Consistent Coverage
Work with state Medicaid agencies to uphold existing protections and resist efforts to restrict care. Advocate for clear, inclusive policies in states with ambiguous regulations.
3. Support Legal Challenges
Partner with legal and advocacy organizations to challenge discriminatory policies and executive orders that threaten access to care.
4. Educate and Train Providers
Invest in training programs to help providers understand the unique needs of transgender individuals and deliver affirming care.
5. Address Social Determinants of Health
Recognize that access to care is only part of the equation. Support initiatives that address housing, employment, and other social factors impacting transgender individuals.
A Commitment to Diversity, Equity, and Inclusion for Gender
Medicaid MCOs should stand firm in their commitment to equitable care, ensuring that all beneficiaries, regardless of gender identity, receive the services they need.
Agilian remains committed in its advocacy for inclusive, affirming care. We will continue to support MCOs in navigating these challenges and protecting access to care for transgender beneficiaries. Together, we can resist these unjust policies and uphold the principles of equity and dignity in healthcare.
For those impacted by these changes, we encourage you to reach out for resources and support. Let’s work together to protect the rights and well-being of all individuals.
Resources:
1. UCLA School of Law Williams Institute. "Medicaid Coverage for Gender-Affirming Care." Medicaid Gender Care
2. PBS News. "The Power of Presidential Executive Orders and Their Limits." PBS News
3. WBAL-TV. "What to Know About Trump’s Transgender Order." WBAL-TV
4. Associated Press. "Trump Day 1: Executive Orders." AP News