Florida agency considers stripping transgender therapies from Medicaid coverage

LGBTQ-advocacy groups say it'll hurt thousands of Floridians
Posted at 5:06 PM, Jul 08, 2022
and last updated 2022-07-08 18:46:45-04

TALLAHASSEE, Fla. — Florida's Agency for Health Care Administration (AHCA) is considering new rules that would strip transgender therapies from Medicaid coverage.

LGBTQ-advocacy groups decry the idea, saying it'll hurt thousands of Floridians.

The state agency published the proposed rule on gender dysphoria in June.

If approved — Florida's more than $30 billion Medicaid program will no longer cover things the following:

  • Puberty-blocking meds 
  • Hormones, or hormone antagonists
  • No sex-reassignment surgeries
  • Nor "other procedures that alter primary or secondary sexual characteristics…"

The rule suggests these treatments don't meet the standard of a "medical necessity."

"A lot of progressives aren't speaking out against these horrible bans that are just attacking trans people and trans children," Sabrina Hartsfield of Tallahassee said.

Sabrina Hartsfield speaks out against Florida's Agency for Health Care Administration considersing new rules on transgender therapies.
Sabrina Hartsfield speaks out against the possibility that Florida's Agency for Health Care Administration would strip transgender therapies from Medicaid coverage.

For two hours Friday, agency officials listened to public comments on the idea. More than 70 people planned to speak during the Tallahassee meeting.

They worry the change could harm an estimated 9,000 transgender Floridians, according to a 2019 UCLA report.

"It's telling trans people in Florida, basically Florida does not care about you," Hartsfield said. "We want to do everything to put your life and livelihood in jeopardy."

In a report, AHCA justified the rule saying there's "insufficient evidence" that the therapies are safe and effective. That's despite groups like the American Academy of Pediatrics supporting them.

"While clinical organizations like the AAP endorse the above treatments, none of those organizations relies on high-quality evidence," the AHCA report said. "Their eminence in the medical community alone does not validate their views in the absence of quality, supporting evidence. To the contrary, the evidence shows that the above treatments pose irreversible consequences, exacerbate or fail to alleviate existing mental health conditions, and cause infertility or sterility."

Bev Kilmer, former Florida House of Representative
Bev Kilmer is among the people who support stripping transgender therapies from Medicaid coverage.

Supporters of the rule, like Bev Kilmer, would agree. The former Florida House representative was handing out stickers at Friday's meeting, each reading "Let Kids Be Kids."

"I do not think that this needs to be provided to children, period," Kilmer said. "It should not be paid for by taxpayers' money," Kilmer said. "It is not an illness. It is not a disease."

LGBTQ-advocacy groups have condemned the proposal as a further attack on transgender Floridians. They cite a 2019 UCLA report that suggests the decision will impact as many as 9,000 in the state.

"This is going to have a deleterious effect on trans people living in Florida who rely on Medicaid as their health insurance coverage," said Carl Charles with Lambda Legal.

Carl Charles, Lambda Legal
Carl Charles outlines the legal ramifications if the new transgender therapy rules are passed in Florida.

Charles said his group was already planning to challenge the rule in court. He said to anticipate a filing soon after its expected approval.

"A rule, such as this, which discriminates on the basis of a person's sex or gender, violates a whole host of constitutional principles and federal statutes," he said.

Public comment continues online until Monday afternoon. After that, AHCA Secretary Simone Marstiller will make a final decision on whether to adopt the rule.