Citing faults in the health insurance system that could leave transgender individuals uncovered, Gov. Andrew Cuomo announced new legislation that will protect access to insurance.
Specifically, according to a circular letter from Health Bureau Chief Lisette Johnson, insurers in the past have had the ability to deny coverage of medical procedures if the procedure is typically performed on a gender the patient does not identify or present as. For example, if a biological female who identifies and presents as male required a cervical exam, the patient could be denied coverage because they are on the record as male.
With Cuomo’s announcement comes a requirement for insurers to no longer immediately deny a claim. Rather, the insurer is expected to take reasonable steps to acquire enough information to decide whether or not the claim should be paid. Simply lacking enough information to understand why a claim which defies a patient’s stated gender has been made will not be an excuse to deny claims that could be medically necessary.
“In New York, we believe that health care is a right, and we are committed to protecting that right for all New Yorkers, regardless of income, age, race, sexuality or gender identity,” Cuomo said, in a release from the New York State Department of Financial Services. “Now, more than ever, we are leading the nation in furthering protections to all New Yorkers that those in Washington seek to eliminate, and we will continue to work to combat discrimination in all forms and ensure equal treatment for all.”
Financial Services Superintendant Maria Vullo echoed Cuomo’s sentiment.
“Transgender persons should not be discriminated against and denied health insurance coverage because of their transgender status nor denied treatment simply due to insurance coding issues. DFS will ensure that all New Yorkers, regardless of gender identity, receive the health insurance coverage they need,” Vullo said.
The announcement falls in line with recent campaign efforts from Cuomo to increase accessibility of healthcare to New Yorkers, including an announcement in June that prevents insurers from discriminating against those with preexisting conditions.