Transgender patients are facing hurdles in accessing treatments like estrogren and testosterone injections in states where gender-affirming care is not guaranteed under Medicaid, Helen Santoro said in an Oct. 5 Kaiser News Network viewpoint piece.
Ms. Santoro said her wife, a transgender woman, lost coverage of her gender-affirming medication after she lost her job and private insurance plan during the pandemic. It was a monthslong battle to eventually gain partial coverage of the treatment, bringing the out-of-pocket cost to $60 per vial.
Twenty-three states and Washington, D.C., provide gender-affirming care in state Medicaid plans, according to the Kaiser News Network piece.
However, even in states where care is mandated, prior authorizations may stand in the way of care, Kellan Baker, PhD, Whitman-Walker Institute executive director, told Ms. Santoro.
Additionally, a study by the national Out2Enroll initiative found that 46 percent of 1,386 surveyed silver marketplace plans covered some or all of gender-affirming treatments, but 14 percent have some exclusions.
LGBTQ adults disproportionately lost employment-provided private insurance as a result of the pandemic, according to a Kaiser Family Foundation report.
