Manchester school board tables transgender health care request

New Hampshire Union Leader

April 11--City school board members voted Monday to table a request to offer transgender-inclusive health-care benefits, including procedures such as sex change surgery, to school district employees and their family members covered under school health insurance plans.

Transgender health care services will be available to employees on the city side in Manchester beginning July 1, following a vote taken last fall by the Board of Mayor and Aldermen. That vote was 10-2 in favor of offering the services.

As previously reported by the New Hampshire Union Leader, Anthem removed the exclusion for gender identity disorders and sex change surgery from its coverage offerings -- on both fully and self-insured plans -- effective Jan. 1, 2017, in accordance with ACA Section 1557, nondiscriminatory provisions of the Affordable Care Act.

Section 1557 prohibits most insurers from discriminating on the basis of sex -- including gender identity -- when providing health coverage. Discrimination on the basis of gender identity includes:

--Blanket exclusions on any transition-related health care services;

--The denial or limitation of coverage for services used for gender transition when those services would normally be covered when treating a non-transition related health condition;

--The refusal to cover treatment that is typically associated with one particular gender, because an individual identifies with another gender or is listed as having another gender in their medical records or on a personal form of identification.

On Monday, school board member John Avard of Ward 10 asked exactly what would be covered if the board included the benefits.

"We would be covering sex change operations basically," said Tom DeLacey, Manchester's health care consultant.

"Isn't that elective surgery?" asked Avard.

"As part of the ACA there was a provision that said it needed to be covered," said DeLacey. "As a self-insured employer we have an option of doing that or not, but the school district could be open to litigation if it does not."

"Post-mastectomy, do we pay for reconstructive surgeries?" asked Avard.

"Yes, we do," said DeLacey.

"I think we need to do some fact-finding and hear from the public," said Avard. "I don't think I'm ready to make a decision on this."

Avard made a motion to table discussion until a future meeting. The motion passed on a voice vote.

The cost to add transgender services to the health plan on the school side is pegged at between 80 cents and $1.10 per member, per month, according to school district Human Resources Director Pamela Hogan. The costs are the same for those enrolled in health plans on the city side.

pfeely@unionleader.com

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