The Pride Agenda believes that everyone should have access to the healthcare they need. The American Medical Association has deemed transgender healthcare as medically necessary and therefore it should be available to those in need - in this case the population that accesses care through Medicaid.

If Medicaid were to cover transgender healthcare, it would actually be a cost saving measure. For what would represent only .0033% of the total Medicaid budget, the state would see savings in mental health, suicide attempts, HIV, substance abuse and other costs that occur when transgender people cannot get their healthcare needs met.

The private sector has recognized the cost efficiency of covering transgender healthcare, as shown by the 25% of Fortune 100 companies that already include it for their employees. California already covers transgender healthcare through Medicaid, as well.

Because New York does not yet collect data on LGBT people or allow us to identify ourselves on state surveys, there is no comprehensive count of how many transgender people there are in New York, though some independent representative data indicates that there are tens of thousands. Not all transgender people need transition health services, and only a fraction of those who do would utilize Medicaid to access this care.

Access to care through Medicaid is just one issue that affects LGBT people. We need better access to community healthcare (i.e. outside of hospitals) so we can receive care in settings that are sensitive to our needs. We need the government to be collecting data on LGBT people so we are not invisible and can have programs that meet the unique needs we have. And we need to make sure same-sex couples are treated the same as opposite sex couples by those who care for us and our families. 

Take Action!

New York is undertaking an evaluation of the state’s Medicaid program. Various proposals have been on the table, including one that would ensure that medically necessary transgender health needs are covered by the program. Call Department of Health Commissioner Nirav Shah at (518) 474-2011 and tell him that all New Yorkers deserve health care, including transgender New Yorkers. More Info > 

Resources

• Resolution Supporting Removing Financial Barriers to Care for Transgender Patients (American Medical Association)
• Policy Statement: Transgender, Gender Identity & Gender Expression Non Discrimination (American Psychological Association)
• 2009 Resolution: Encourage Removal of Health Insurance Restrictions for Care of Transgender Patients (American Academy of Family Physicians)
• Policy Statement: Transgender and Gender Identity Issues (National Association of Social Workers)
• WPATH Clarification on Medical Necessity of Treatment, Sex Reassignment and Insurance (World Professional Association for Transgender Health)
• Transition Related Health Care (Lambda Legal)
• Eliminating the Medicaid Exclusion for Transition-Related Care in NYS: Good Public Health, the Right Thing to Do and Ultimately a Cost­-Saving Measure (Sylvia Rivera Law Project)
• Transgender Medicaid Project Final Report (Empire Justice Center, Sylvia Rivera Law Project, researcher Jo Rees and The Legal Aid Society)

Reports commissioned by the Pride Agenda for the New York State LGBT Health and Human Services Network

• A Blueprint for Meeting LGBT Health and Human Services Needs in New York State (Hunter College, City University of New York, 2010)
• LGBT Health and Human Services Needs in New York State (Somjen Frazer, 2009)