Transgender state employees in Washington will soon be assured of getting health coverage, including office visits, hormonal treatment and mental health care.
Coverage could begin as soon as January 2015 under a plan approved by a state board Thursday. Coverage of surgical needs will have to wait another six months, to July 1.
The unanimous vote by the Public Employees Benefits brings an end to exclusions that some employee health plans used to deny services for transgender people. The vote drew immediate praise from advocacy groups, including a few people who attended the meeting and broke out in applause when the vote was recorded.
“We’re definitely very happy with the vote,” said Tobi Hill-Meyer, who serves as external director for the Gender Justice League, a Seattle advocacy group. “This move brings things more in line with the decisions that more and more states are making in recognizing that these exclusions are an illegal discriminatory practice ... It will have a significant impact on people's health and well-being.''
The PEBB also voted to lock in premium rates that are rising slightly for state employees next year in several plans, while dropping in a few. In the Uniform Medical Plan Classic, which serves about 60 percent of workers, final rates rise $5 to $84 per month for an individual subscriber and go up $14 for a $241 monthly charge for full family coverage.
Greg Devereux, executive leader of the Washington Federation of State Employees, sits on PEBB and voted against the plan. “This is a tough one for me,” Devereux said. He said what is driving up costs is utilization, but noted that state employees have not received a cost of living adjustment in pay for six years, while providers have seen rates go up.
“I think providers and others should also take a hit in that regard,’’ Devereux said. But he praised the Health Care Authority and PEBB staff for negotiating rates that went down in some cases.
Board member Gwen Rench, representing retirees, also voted against several of the plan premium increases.
Under final adjustments to rates over the past week by PEBB staffers, subscribers to Group Health Classic, the third-most-popular plan that serves nearly one in eight state workers, rates fall by $10 per month to $107 for single subscribers. They drop $28 per month to $304 for full family coverage. Both downward adjustments were less than outlined earlier in July by PEBB.
The issue of covering people with gender dysphoria, a recognized medical condition affecting those who are not comfortable with their birth gender, was brought to the board months ago by advocates. They asked that transgender services be covered in plans much sooner than Health Care Authority staff believed was possible.
As recently as two weeks ago, HCA proposed that coverage of office visits, hormones and mental health care begin Jan. 1, 2015, but that surgical coverage be delayed until January 2016.
Advocates pushed back and some lawmakers also asked questions, according to Devereux, whose union backed the broader coverage on grounds that denials of care were unfair.
This week, HCA moved the date for surgical coverage by six months.
Adding coverage for transgender people adds potentially $1 per month per subscriber, according to PEBB staff.
The expansion of benefits echoes similar moves elsewhere. Washington state Insurance Commissioner Mike Kreidler recently sent a letter to insurers asking them to drop exclusions on grounds they were discriminatory.
“We applaud the PEBB for their leadership on this critical issue,” Marsha Botzer, member of the Coalition for Inclusive Healthcare,, said in a news release issued by Pride Foundation. “This victory ensures that transgender public employees throughout the state will have access to life-saving and medically necessary healthcare.”
Advocates cited higher suicide rates among transgender people than the general population.
“Providing the full range of services to transgender individuals is literally a matter of life and death,” added Seth Kirby, board president of Pride Foundation, in the release. “PEBB’s decision sends a clear message to transgender individuals that they matter, and paves the way for other employers to follow suit.”