Illinois Medicaid program to cover gender reassignment surgeries
A demonstrator protests for transgender rights during a rally in Chicago, Illinois, on Feb. 25, 2017. (Photo by Scott Olson/Getty Images)
SPRINGFIELD, Ill. - The state of Illinois' Medicaid program will cover gender reassignment surgeries for members age 21 and older who have been diagnosed with gender dysphoria.
Illinois’ Department of Healthcare and Family Services said Friday that it has already started developing administrative rules for the coverage. Once the rule is enacted, members should be eligible for coverage by summertime.
Under proposed coverage rules, Medicaid members 21 and older who are diagnosed with gender dysphoria will be able to receive genital and breast-related surgeries.
“Healthcare is a right, not a privilege, and I’m committed to ensuring our LGBTQ community and all Illinoisians have access to the right,” Gov. J.B. Pritzker 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.”
The state’s health department studied other policies and found that gender-affirming surgery can be cost effective. Some of those policies, such as in Vermont, offer a comprehensive approach with a similar model.
Seventeen states, including the District of Columbia, offer similar services and have not reported a significant cost increase.
Illinois has 3.1 million Medicaid members and 1,400 of them are diagnosed with gender dysphoria, according to the health department. In 2018, about 2,500 prescriptions for hormone therapy were covered.
In 2016, the U.S. Department of Health and Human Services set rules to require access to gender transition services, but Illinois’ previous health administration had not created policies and coverage requirements.
This story was reported from Los Angeles.