Florida bans Medicaid from covering gender-affirming treatments

TALLAHASSEE, Fla. — Florida’s Medicaid regulator has finalized new rules banning health care providers from billing the taxpayer-funded program for gender-affirming medical treatments, a move that comes as the state has sought to block such therapies for young people.

The Florida Agency for Health Care Administration on Thursday added new language to the rules governing the state’s $36.2 billion Medicaid program. The new rules declare that the program does not cover services for treatments such as puberty blockers, hormone therapies or surgical procedures as a treatment for gender dysphoria, which refers to the feelings of discomfort or distress some transgender people experience when their bodies don’t align with their gender.

The updated rule will take effect on Aug. 21.

The new rule is the latest step by Gov. Ron DeSantis to restrict gender-affirming treatments. Last Friday, Florida’s medical board voted to start the rulemaking process that could lead to the banning of gender-affirming medical treatment for youths. And the Republican Florida governor has become increasing vocal in his objections to such treatments.

The American Academy of Pediatrics and the American Medical Association support gender-affirming care for adults and adolescents. But medical experts said gender-affirming care for children rarely, if ever, includes surgery. Instead, doctors are more likely to recommend counseling, social transitioning and hormone replacement therapy.

A coalition of LGBTQ and health rights groups, including Lambda Legal, Southern Legal Counsel, Florida Health Justice Project, and National Health Law Program, said the rule will leave thousands of transgender Floridians without critical care when they need it most.

“Ignoring thousands of public comments and expert testimony, Florida’s AHCA has finalized a rule that will deny Medicaid coverage for all medically necessary gender-affirming care for both youth and adults,” the coalition statement said. “This discriminatory and medically unsound rule will take effect on August 21, 2022, putting transgender people in jeopardy of losing access to critical gender-affirming health care services.”

The move by Florida’s Agency for Health Care Administration to ban Medicaid from covering such treatments began in April after the agency published a report claiming there was not enough scientific evidence to prove that the treatments improved health. AHCA held a public hearing on the new language in June that attracted more than 150 people on a late Friday afternoon.

Florida’s Department of Health also accused the U.S. Department of Health and Human Services and the American Academy of Pediatrics of misleading the public into believing the treatments are safe.

The American Academy of Pediatrics, however, has ramped up efforts to protect transgender youths amid an increase in states pushing legislation aimed at preventing minors from accessing gender-affirming care or transgender girls participating in women and girls’ sports.

“It is critically important for every child to have access to quality, comprehensive and evidence-based care — transgender and gender-diverse youth are no exception,” said Lee Savio Beers, American Academy of Pediatrics immediate past president in a statement earlier this year.