FAYETTEVILLE -- Gender transition treatments will not be covered by University of Arkansas System employee insurance plans after a decision to suspend coverage set for implementation Jan. 1.
The UA System's self-funded insurance plans for employees will cover services received on or before March 6.
But legal advocates for the transgender community questioned the UA System's reasoning for suspending coverage after that date. The UA System, in a message to campuses, cited an injunction in an ongoing federal district court case in Texas.
A judge on Dec. 31 ordered a halt to federal Health and Human Services enforcement of regulations addressing gender identity and the Patient Protection and Affordable Care Act, sometimes referred to as the ACA.
In the message to campuses, the UA System said it planned to include gender dysphoria coverage in order to comply with Affordable Care Act regulations issued in 2016.
The message continued: "Given the most current court ruling, the University will suspend gender dysphoria coverage pending the final legal outcome of the injunction or further clarification of the ACA coverage guidelines."
The UA System has about 35,900 people on its health plans, spokesman Nate Hinkel said. The total includes employees and families. Hinkel said he had no estimate on the number of insurance claims made relating to gender dysphoria, defined as feeling that emotional and psychological identity is opposite of one's biological sex.
Kenneth Upton, senior counsel for Lambda Legal, a national nonprofit group working for the civil rights of gays, bisexuals and transgender people, said while the injunction may prevent Health and Human Services from enforcing the regulations, "what it didn't do was keep a private individual from suing their employer directly."
He said the Affordable Care Act hasn't been repealed, despite an executive order by President Donald Trump to begin waiving provisions of the law. The law continues to prohibit a blanket denial of gender transition health services, Upton said.
Upton said it isn't clear what portions of the law may be kept and which ones scrapped.
"The truth is it's a very complicated law," Upton said.
Hinkel, the spokesman for the UA System, referred to the message sent to campuses when asked about the reasoning behind the decision to suspend coverage. The decision wasn't made by trustees, but involved the UA System's attorneys, human resources department and health plan administrator, Hinkel said.
At the University of Missouri System, employee health plans continue to cover gender transition treatments, said spokesman John Fougere.
Janson Wu, executive director of the Boston-based GLBTQ Legal Advocates & Defenders, said the judge's order in the Texas case "has nothing to do" with a decision to suspend benefits.
Halting coverage is "not only devastating, but it's harmful to people's health and well-being," Wu said.
Teri Wright, 46, is a transgender woman and U.S. Army veteran who lives in West Fork with her spouse, Katie, a UA System Division of Agriculture employee. Wright said the decision means her struggle for health care coverage continues.
"I cried so hard. It was a shock to me," said Wright, describing how she received the email Tuesday coverage would be suspended. The couple traveled to the Dallas area earlier this month for a consultation on gender reassignment surgery, thinking it would likely happen sometime in the next three to six months.
"Once I would get the surgery, I could cut down on my medications by probably half," said Wright, adding the surgery -- which she said costs an estimated $17,500, not including follow-up -- is only one aspect of health treatment she has found difficult because of exclusions in her partner's plan.
Wright said she receives care because of her status as a veteran through the U.S. Department of Veterans Affairs, but must travel to Little Rock for regular visits to an endocrinologist through the VA rather than see a local specialist as she would be able to on a university health plan.
While the VA covers hormone replacement therapy, Katie Wright, a food science project manager, said costs add up for other health expenses relating to her spouse's transition treatments like lab work bills of $2,000 to $3,000 yearly, she said.
Teri Wright said the gender reassignment surgery is medically necessary, not only to cut down on liver-damaging medications but also so she can live her life as she wants to: Swimming, going to yoga, not having worries in a public restroom.
The couple doesn't want to move, but they have considered it, Katie Wright said.
"We've talked about just Teri moving away to one of these other states for awhile, separating so she could get the coverage she needs. Our options aren't very fun," Katie Wright said.
In 2014, UA added "gender identity" to its non-discrimination policy on the advice of the UA System, which cited a President Barack Obama executive order prohibiting federal contractors from discriminating based on gender identity.
The policy, still in place, applies to employment decisions, including "fringe benefits."
Of the decision to suspend gender dysphoria coverage, Teri Wright said, "I do see it as discrimination."
NW News on 01/28/2017