Blue Cross Blue Shield of Michigan to Drop Coverage for Gender Reassignment Surgery

Todd Heywood

A broad coalition of organizations are condemning a move by Blue Cross Blue Shield of Michigan to eliminate coverage for gender reassignment surgery.

A broad
coalition of organizations, including the American Civil Liberties
Union, The National Association of Social Workers, Transgender Michigan
and others, are condemning a move by Blue Cross Blue Shield of Michigan
to eliminate coverage for gender reassignment surgery. The new entity
calls itself The Michigan Coalition for Gender Equality.

“We are concerned that BCBSM underestimates the profound impact of
these medically necessary procedures,” said André Wilson of MCGE.
“Gender reassignment surgeries can be a critical part of the transition
process and these new exclusions will place many transgender
individuals and their families at real risk.”

The change was approved in Feb. says Jason Moon, a spokesman for the
Office of Financial and Insurance Regulation. He called the change
“unfortunate,” but noted the law did not define gender reassignment
surgery as a necessary medical care area. Moon said such areas were
things like breast cancer and diabetes.

Gender reassignment surgery is often used to treat gender dysphoria,
the medical diagnosis given to transgender persons. The surgery is
considered medically necessary by advocates and the American Medical Association.

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Julie Nemecek, co-director of Michigan Equality, said the state’s
comment about the change being “unfortunate,” gave her hope the policy
might change again.

“It gives me a lot of encouragement they recognize how bad a decision it was on their part,” said Nemecek.

Gender reassignment surgery can cost $20,000 over a two year time period.

Stojic, spokesperson for Blue Cross Blue Shield of Michigan, says the
decision by the insurer to eliminate coverage of gender reassignment
was simply a matter of aligning their product with what is currently
offered in the market.

“We took a look at our product line and what other insurers were
covering in other markets,” she said in a phone interview late Tuesday
night. “Most don’t cover this type of surgery. So we are aligned our

Michigan Messenger reported Tuesday that BCBS of Michigan had received permission from state regulators to change insurance coverage offerings, and elimination of gender reassignment surgery was one of those approved changes.

Stojic said the insurer, which is mandated by state law to offer
coverage to those other insurers will not cover, reduced the cap for
maternity coverage in the new alignment as well. The changes impact
only single payer plans.

Stojic said the company posted a $133 million loss in the single
payer plans last year, but could not give an estimate of how much of
that was a result of gender reassignment surgery.

The decision, approved in Feb. has been decried by a coalition of
groups working for gender equality, and state regulators called the
decision “unfortunate.” Stojic was not particularly warm to the
concerns expressed, however.

“We certainly understand that people who are particularly interested
in [transgender health] may not be happy with [coverage elimination],”
she said. “We have to compete in the market.”

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