Medi-Cal Expansion Will Boost Transgender Health Services
Medi-Cal expansion under the Affordable Care Act could enable transgender patients in California to obtain sex reassignment surgery, hormone replacement therapy and other transgender-specific health care services, KQED's "State of Health" reports. Medi-Cal is California's Medicaid program.
The California Supreme Court in 2001 ruled that Medi-Cal must cover "medically-necessary treatment," which includes sex reassignment surgery.
However, Dawn Harbatkin -- executive director of Lyon Martin Health Services, a San Francisco health clinic that focuses on LGBT-related health care -- said the majority of providers in the state would not cover the surgery because Medi-Cal reimbursement rates were too low.
Expansion of Transgender Care
Recently, California has begun shifting Medi-Cal beneficiaries to managed care plans. Sex reassignment surgery and other transgender-related health care services now are covered by two health plans that contract with the program:
- Anthem Blue Cross; and
- San Francisco Health Plan.
In addition, a San Francisco Department of Public Health last summer launched an initiative, called the Transgender Health Project, aimed at providing information about new laws related to low-income transgender patients to:
- Hospitals; and
Advocates and providers say that access to transgender-specific health services will improve such patients' physical and mental health.
Nick Gorton, a primary care physician at Lyon Martin, said, "In my experience I've seen so many trans people who have mental health problems, who have depression, anxiety, they're suicidal -- from a mental health perspective, their world has just kind of collapsed onto them." He added, "Then they get hormones, they get surgery, they get access to treatment, and it's like you've flipped a light switch on."
Observers say that hospitals across the state still are determining how to implement federal and state regulations related to transgender health care (Hart, "State of Health," KQED, 2/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.