More than 40% lack guaranteed access to coverage for gender-affirming care under state law
An estimated 276,000 transgender adults are enrolled in Medicaid in the U.S., according to a new analysis by the Williams Institute at UCLA School of Law. Twenty-five states and D.C. have chosen to specifically include coverage for gender-affirming care under their Medicaid programs or are in the process of extending coverage, while 14 states exclude coverage for such care and 18 states have not expressly addressed coverage.
Gender-affirming care includes a range of services, such as surgical procedures, hormone therapy, and other forms of treatment related to gender transition.
1.3 million adults in the U.S. identify as transgender and approximately 276,000 of them are enrolled in Medicaid.
An estimated 60% (164,000) of transgender Medicaid beneficiaries live in states with express policies guaranteeing coverage for gender-affirming care.
For 27% (74,000) of transgender Medicaid beneficiaries, coverage is uncertain because they live in states where the laws are silent on coverage for gender-affirming care.
The remaining 14% (38,000) of transgender Medicaid beneficiaries do not have access to covered gender-affirming care because they live in states with express bans on coverage.
"This patchwork of protections creates uncertainty for transgender people who are enrolled in Medicaid," said lead author Christy Mallory, Legal Director at the Williams Institute. "Additional policy changes in states that still have bans or lack clear language addressing coverage would ensure that transgender Medicaid beneficiaries have access to coverage for gender-affirming medical care no matter where they live."
Read the report at williamsinstitute.law.ucla.edu/publications/medicaid-trans-health-care/ .