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Pennsylvania Medicaid Removes Trans Health Exclusions!


On Monday, the Pennsylvania Department of Human Services announced that the state Medicaid program will now cover all medically necessary gender transition services. This exciting policy change brings Pennsylvania’s Medicaid program into compliance with the federal Affordable Care Act (Obamacare), which prohibits blanket exclusions of transition-related care Medicaid programs and most other health insurance plans.

Pennsylvania is the twelfth state, in addition to the District of Columbia, to explicitly cover transition-related care in their Medicaid program. This victory is means that low-income transgender Pennsylvanians can have access to the medical care they need. The program will determine whether a procedure is medically necessary based on the widely accepted guidelines set by the World Professional Association of Transgender Health.

The announcement follows another important healthcare win in Pennsylvania in April of this year, when the Pennsylvania Insurance Commissioner issued guidance banning transition-related exclusions in private insurance plans in the state.

You can find the Department of Human Services guidance documents here, here, and here.

NCTE worked with Equality Pennsylvania and the Mazzoni Center to help the Department of Human Services develop this important guidance, and we congratulate all of the state advocates who worked on ensuring that transgender Pennsylvanians can access life-saving care. We continue to work with other state to update their Medicaid policies to include transition-related care and come into compliance with federal law.

If you have faced discrimination in health care or health insurance coverage, including Medicaid, check out our Know Your Rights: Healthcare resource or get legal help.

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