Ore. Adds Gender Reassignment to Health Care Coverage

January 25, 2013 (PLANSPONSOR.com) – A lawsuit has led the state of Oregon to offer health care coverage for gender reassignment for state employees.

The state reached an out-of-court settlement with a public employee who filed a discrimination suit after he was denied insurance coverage for a hysterectomy related to his transition from a woman to a man. The settlement requires the state to pay the employee $36,000 and change its policies to provide insurance coverage for all operations, prescription drugs and other treatments related to medically necessary gender-reassignment surgeries, the Statesman Journal reports.  

The lawsuit stated Oregon law has prohibited private insurance companies from discriminating based on gender or sexuality since 2007, and the Public Employee Benefits Board (PEBB) should follow the same laws. The suit contended that denial of coverage for the surgery was discrimination because the state does cover hysterectomies and only denied the employee because of his diagnosis of gender identity disorder.  

At the time of his surgery, PEBB policies prohibited coverage for treatment related to “sexual disorders,” which specifically precluded coverage related to gender reassignment operations. PEBB administrator Joan Kapowich said the board has not tracked how many gender-reassignment procedures are done each year and has no estimate on how much the new policy will cost.