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Monday, March 28, 2016

Delaware Becomes 15th State to Ban Trans Health Exclusions

NCTE celebrates Delaware joining a national trend of states prohibiting health insurance exclusions that target transgender people. Delaware joins California, Colorado, Connecticut, Illinois, Massachusetts, Michigan, Minnesota, Maine, Nevada, New York, Rhode Island, Oregon, Vermont, Washington State, and the District of Columbia, as well as the federal Medicare program, in banning these exclusions, which are contrary to medical science and federal and state laws.

Delaware’s insurance bulletin specifically prohibits “the denial, cancellation, termination, limitation, refusal to issue or renew, or restriction, of insurance coverage or benefits because of a person’s gender identity or transgender status, or because the person is undergoing gender transition.” Insurance Commissioner Karen Welden Stewart said, “All Delawareans should have access to quality health care, regardless of their gender identity.”

The bulletin states that under the Delaware Unfair Trade practices act, insurance plans sold in Delaware may not maintain “any blanket policy exclusion” for transition-related care. Plans also may not “deny, exclude, or otherwise limit coverage for medically necessary services” for gender transition if those services are covered for other medical conditions. The bulletin says that “determinations of medical necessity, eligibility, and prior authorization requirements for diagnoses related to an insured’s gender identity [should be] based on current medical standards established by nationally recognized transgender health medical experts.” It also makes clear that even though, like many states, Delaware’s state “benchmark” for its health insurance exchange is based on an existing plan with a transgender exclusion, insurance companies may not copy that exclusion into their own plans.

NCTE applauds Delaware for taking this necessary step in making sure that medically necessary transition-related healthcare is accessible to transgender people. We urge people in Delaware and around the country to consult our Healthcare Know Your Rights resource, and to contact trans-friendly legal organizations if they are denied transition-related care recommended by their provider.

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