Illinois to ensure Medicaid coverage of gender-affirming surgery

Illinois’ Medicaid program will soon ensure coverage of gender-affirming surgeries for transgender adults who meet certain diagnostic criteria, the state’s Department of Healthcare and Family Services said in a release.

The department is developing rules for the coverage, and it’s likely to be adopted this summer, according to the release.

Medicaid members must be at least 21 years old and have a diagnosis of gender dysphoria, a term that describes the distress people suffer when the gender they identify with doesn’t match the gender assigned to them at birth.

“For those facing gender dysphoria, every day can be a painful challenge, Theresa Eagleson, HFS director, said in the statement. “Helping these individuals overcome their struggles through compassionate and comprehensive treatment is the right approach for them and for Illinois.”

Expanding Medicaid coverage of the procedure would be cost-effective, the department said, since it prevents “negative health impacts,” including depression and suicide. HFS is using Vermont’s policies as a model, it said. Cost increases have not been reported by 17 states, and the District of Columbia, that offer this coverage, the department said.

In a study published in September, transgender teens reported the highest rates of suicide attempts. Among transgender male teens, almost 51% said they had tried to take their lives, the study said.

“Expanding Medicaid to cover gender affirming surgeries is cost effective, helps avoid long-term health consequences, and most importantly is the right thing to do,” Gov. J. B. Pritzker said in the release.

CNN has reached out to the department for comment on the policy change, but hasn’t yet had a response.

The US Department of Health and Human Services in 2016 made a rule that interpreted the ban on sex discrimination to include discrimination on the basis of gender identity in federally funded health care facilities and insurance plans. The Illinois HFS said the previous administration didn’t “create the policies and coverage requirements to accomplish this.”

The Trump administration has signaled it intends to undo the rule.