Idaho bill: gender-affirming care could ‘cost the taxpayers millions,’ critics say

House Bill 668 would forbid public dollars from being spent on any “medical intervention” or surgery that alters the “appearance” of a person “in a way that is inconsistent with the individual’s biological sex.” The prohibition would apply to health care providers employed by the state or local governments.

Rep. Julianne Young, R-Blackfoot, co-sponsored the bill and told a legislative committee Thursday that gender-affirming health care is “controversial at best” and interrupts “normal healthy sexual development.” The proposal passed in the House this month and has been sent to the Senate floor.

The bill from Young and Rep. Bruce Skaug, R-Nampa, is the latest in a line of bills aimed at the transgender community in recent years. At Thursday’s hearing, transgender residents and their supporters testified that the bill discriminates against them and could lead to higher rates of depression and suicide.

“Gender-affirming care for me — I am so incredibly happy in my life,” said Saga Christian, who said they used to be homeless, severely unhappy and suicidal. “This care has saved my life. And I wake up every morning just incredibly happy, and I’ve never understood how someone could have this much joy.”

Lily Pannkuk, who spoke against the bill, noted that the bill doesn’t block specific medications, such as puberty blockers and hormone treatments, if they’re used to affirm a person’s biological sex. “It’s blocking specific identities of people from accessing medication that everyone gets access to.”

One family physician in Boise, Marvin Alviso, said he doesn’t know how he would treat patients suffering from gender dysphoria who are on Medicaid if the bill becomes law.

Idaho bill will ‘cost the taxpayers’

Some opponents of the bill called it unconstitutional.

“This bill violates the 14th Amendment’s equal protection clause,” said Howard Belodoff, a Boise attorney. Belodoff represents transgender clients in a lawsuit against Idaho’s policy that deems genital reconstruction surgery cosmetic and not medically necessary.

The bill violates the federal Medicaid law, Belodoff said, which doesn’t allow restrictions on care based on type of diagnosis or condition. If enacted, the bill would almost certainly be challenged in court, he added.

“This is going to cost the taxpayers millions of dollars,” he said.

Idaho was ordered to pay $2.5 million in attorneys fees in 2022 after the state lost a lawsuit from a transgender prisoner who was denied gender confirmation surgery.

Last year Gov. Brad Little signed into law a policy to outlaw gender-affirming care for children. A federal judge in Idaho stopped the law from going into effect late last year and ruled it was likely unconstitutional. Attorney General Raúl Labrador has appealed that case to the U.S. Supreme Court.

Impact on state insurance coverage unclear

It is unclear how the bill would affect state employees. Starting in July, the state is scheduled to switch to a new health insurance provider, Regence BlueShield. The company and the state Department of Administration, which oversees state health care policies, did not immediately respond to requests for comment.

Young previously told the Idaho Statesman that she didn’t know how her bill would affect insurance coverage because insurance contracts are subject to negotiation.

One testifier, Isaac Craghtten, raised concerns that the broad language of the bill could potentially make it illegal for a transgender person to take prescribed hormone medication at work on state property or on school campuses.

Bill sent to Senate on narrow vote

Sen. Melissa Wintrow, D-Boise, said the bill was discriminatory and voted against it in the Senate committee. She was joined by Sen. James Ruchti, D-Pocatello, and Sen. Jim Guthrie, R-McCammon, who said he had been convinced by the testimony against it and worried about future lawsuits and the “discrimination.”

Twice during the hearing, Sen. Treg Bernt, R-Meridian, thanked trans testifiers for coming to speak. “I appreciate your courage,” he told Nikson Mathews. Bernt voted for the bill, which was sent to the floor by a 4-3 vote.

Mathews, who is transgender and has filed to run for a House seat in Boise, told lawmakers that medical research shows gender-affirming care generally leads to improved health outcomes and saves lives.

“If that is not medically necessary, I don’t know what is,” they said.

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