A memo sent to the Group Insurance Board last week by the Wisconsin Department of Justice (DOJ) is asking the former to reconsider its July 12 decision to cover for the costs of gender reassignment surgery for state workers starting next year.
The insurance board did not take any action on the changes at a meeting Tuesday, reported
Wisconsin State Journal.
DOJ deputy attorney general Andy Cook explained in the memo that the board’s decision was based on “unlawful” federal rules from the Affordable Care Act (ACA). Cook argued that the board’s rules “improperly reinterpret” Title IX, which covers discrimination on the basis of sex, to apply to gender identity.
“Nowhere in the Congressional debates over Title IX does the phrase ‘gender identity’ or ‘transgender’ appear,” Cook asserted.
It was the state Department of Employee Trust Funds (ETF) that had previously advised the insurance board to cover for gender reassignment services, asserting that it was required by the new federal rules.
ETF responded to the DOJ memo, saying that failing to cover for the services could endanger the state’s capability to contract with health insurance companies. The agency also warned that the state could lose about $36 million per year in Medicare subsidies if the board rescinds its decision.
“ETF recommended those changes after careful review of the (federal) rule,” said David Nispel and Diana Felsmann of the ETF.
Cook commented that by ending the state’s previous exclusion of coverage for gender reassignment services, the ETF is encouraging that all similar services be covered even if they are not medically necessary.
Nispel and Felsmann, however, disagreed with Cook’s opinion, saying that health plans can still deny services that are not medically necessary.
According to ETF spokesman Mark Lamkins, the department is proceeding with the board’s decision.
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