WASHINGTON — In a relatively quiet announcement Friday, the Obama administration struck a major blow for transgender rights by ending a decades-long blanket ban that prevented Medicare from covering sex reassignment surgery.
The Department of Health and Human Services’ Departmental Appeals Board, an internal review structure within the byzantine federal agency, issued a ruling that ended a ban on Medicare even considering covering sex reassignment surgery and related care because a fear of “serious complications” resulting from the “experimental” surgery. That language was issued in 1981, and most medical professional organizations now consider sex reassignment surgery a safe and accepted procedure. The DAB ruling noted the change in how sex reassignment surgery is understood 33 years after the Medicare ban was issued.
“Even assuming the [National Coverage Determination]’s exclusion of coverage at the time the NCO was adopted was reasonable, that coverage exclusion is no longer reasonable,” reads the ruling. “This record includes expert medical testimony and studies published in the years after publication of the NCO.”
Experts say the change to Medicare could have far-reaching implications for American medicine, helping to drive more private insurers to offer coverage for sex reassignment surgery and related care. Though it fits within President Obama’s promise to make the government fairer to LGBT Americans, the DAB announcement was a relatively quiet one. The White House did not trumpet the move, and advocates for the change issued a joint statement hailing it but downplaying it as a revolutionary change for transgender people, instead casting it as bringing Medicare up to speed with the rest of the medical profession.
“This decision removes a threshold barrier to coverage for medical care for transgender people under Medicare,” leaders of the ACLU, Gay & Lesbian Advocates & Defenders and the National Center for Lesbian Rights — the groups that fought for the change — said. “It is consistent with the consensus of the medical and scientific community that access to gender transition-related care is medically necessary for many people with gender dysphoria.”