A bill was passed May 5 in the Hawaii State Legislature that would ban payers from applying "categorical cosmetic or blanket exclusions" for transgender individuals with prescribed gender confirmation treatments or procedures.
Despite a 2016 state law that prohibits payers from discriminating against transgender people, some still deny coverage for gender-affirming care by claiming services are cosmetic and not medically necessary.
The new bill would require payers to cover hormone therapies, hysterectomies, mastectomies, vocal training, feminizing vaginoplasty, masculinization phalloplasties, metoidioplasties, breast augmentations, masculinizing chest surgeries, facial surgeries, reduction thyroid chondroplasties, voice surgeries and therapies, and electrolysis or laser hair removal.
The legislation would also create an appeals process for claims denied over medical necessity and would require payers to provide applicants with clear coverage information.
Kaiser Permanente and the Hawaii Medical Service Association say they support the intent behind the bill but are concerned it could raise costs and premiums, according to the Honolulu Civil Beat.
HMSA's assistant vice president, Matthew Sasaki, has previously testified that the additional procedures would cost the organization $7.7 million.
Democratic Gov. David Ige has until June 27 to announce a veto of the bill.