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Florida bans Medicaid coverage for gender-affirming healthcare

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An HRC billboard in Florida. Photo: HRC

The Florida Agency for Health Care Administration has finalized new rules banning healthcare providers from billing the state’s Medicaid program for gender-affirming care. Under the new rules, puberty blockers, hormone therapies, and surgical procedures for the treatment of gender dysphoria will not be covered for patients of any age.

The new rule will take effect on August 21.

Lambda Legal, Southern Legal Counsel, Florida Health Justice Project, National Health Law Program, and other LGBTQ and health rights groups released a joint statement decrying the move.

“Ignoring thousands of public comments and expert testimony, Florida’s AHCA has finalized a rule that will deny Medicaid coverage for all medically necessary gender-affirming care for both youth and adults,” the statement read. “This discriminatory and medically unsound rule will take effect on August 21, 2022, putting transgender people in jeopardy of losing access to critical gender-affirming health care services.”

The change was first proposed in June, based on a report commissioned by Florida’s AHCA primarily on the effects of gender-affirming care on children. The report’s findings contradict the overwhelming consensus of all major medical organizations.

Gender-affirming care for both adolescents and adults has been endorsed by the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and many other professional groups as necessary and frequently lifesaving for transgender individuals. Treatment for children rarely, if ever, involves surgery, according to experts.

Last week, Florida’s Board of Medicine voted to begin the process of adopting a new standard of care for transgender individuals which could ban gender-affirming care for minors in the state outright.

The new rules proposed by Florida’s Health Department in April would prohibit gender-affirming surgical procedures, medications like puberty blockers and hormone therapy, and “any other procedure that alters primary or secondary sexual characteristics for the treatment of gender dysphoria” for patients under 18, even though gender affirming surgery is not performed on minors. They would also institute a mandatory 24-hour waiting period for adults seeking gender-affirming care.

At least two other states that attempted similar Medicaid bans had them knocked down by federal judges. In 2019, a federal judge ruled that Wisconsin’s Medicaid program must cover gender-affirming care. In West Virginia earlier this month, U.S. District Court Judge Robert C. Chambers overturned the state’s rule which had denied coverage for gender-affirming care since 2013.

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