Florida rule would eliminate Medicaid coverage for gender-affirming care

Florida’s Medicaid program under the proposed rule would exclude coverage for puberty blockers, hormones, gender-affirming surgeries and other interventions when they are used to treat gender dysphoria.

by Brooke Migdon | Jun. 17, 2022

Florida Gov. Ron DeSantis (R) Getty Images

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Florida’s Agency for Health Care Administration on Friday published a notice for a proposed rule that would eliminate Medicaid coverage for gender-affirming health care.

The rule follows guidance released by the state’s Health Department in April that said children younger than 18 years old should not receive gender-affirming care at all, including social transition.

The rule could affect an estimated 9,000 transgender Floridians, according to the group Equality Florida.

Florida Gov. Ron DeSantis’ (R) administration on Friday advanced a proposal to deny Medicaid coverage for gender-affirming medical care like puberty blockers and hormone therapy for transgender residents.

The state’s Agency for Health Care Administration (AHCA), which controls most of its Medicaid program, published a notice for a proposed rule to eliminate coverage for gender-affirming health care.

Under the rule, Florida’s Medicaid program would exclude coverage for puberty blockers, hormones, gender-affirming surgeries or “any other procedures that alter primary or secondary

sexual characteristics” when those interventions are used to treat gender dysphoria.

The proposed rule follows an AHCA report released earlier this month claiming several treatments for gender dysphoria, including puberty blockers, hormones and surgery, are inconsistent with “generally accepted professional medical standards” and are “experimental and investigational with the potential for harmful long term affects.”

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The report builds on guidance released by Florida’s Health Department in April which said children younger than 18 years old should not receive gender-affirming care at all, citing a trend of “low-quality evidence” in studies of treatments like gender-affirming hormone therapy.

The department also cautioned against social transition – the only form of gender-affirming care that is condoned for prepubescent children – which could be as little as a haircut or a change of clothes.

The guidance has been criticized for ignoring mainstream science, and medical experts and LGBTQ+ advocates have accused the department of intentionally disseminating false information to further a conservative political agenda.

That message was delivered again on Friday, this time directed at the AHCA.

“Health care should be driven by scientific consensus, not political pandering or an election cycle,” Nikole Parker, the director of transgender equality at Equality Florida, a Florida LGBTQ+ nonprofit organization, said in a statement. “Access to healthcare is a right every human being deserves.”

Access to gender-affirming care, including puberty blockers and hormone therapy, is supported by most major medical associations, including the American Medical Association, the American Academy of Pediatrics, The World Professional Association of Transgender Health (WPATH) and the Endocrine Society.

According to Equality Florida, should the rule be enacted, an estimated 9,000 transgender Floridians insured with Medicaid could be impacted.

Sarah Warbelow, legal director of the Human Rights Campaign, on Friday said the rule should be “rejected summarily,” and accused the ACHA of “willfully misinterpreting studies, ignoring evidence, and lending credence to prejudice.”

“In the process, they are putting the state between patients and doctors for no reason other than political grandstanding,” she said.

Public comment on the proposed rule is being accepted through July 8. Gov. DeSantis’ office did not immediately respond to Changing America’s request for comment.