November 10, 2017 at 3:29 PM
Del.-elect Danica Roem, the transgender woman who is perhaps the best known of the flood of Democrats who won seats this week in the Virginia state house, said Friday that she wants to make it easier for people to get health insurance coverage for treatment related to gender transitions.
Roem (Prince William), who plans to focus mostly on easing traffic congestion in her district, said she also wants to work with the Democratic caucus in the House of Delegates to develop a bill that would require insurance companies to cover the costs of hormone medication, surgery and other treatments.
That kind of coverage already is mandated for most insurance plans under a 2016 anti-discrimination regulation that is part of the Affordable Care Act. But amid Republican efforts to repeal and replace Obamacare, the Trump administration has threatened to do away with the statute, LGBT advocates say.
"LGBTQ health care is health care," Roem, who will be the first transgender elected official in Virginia, said Friday during a conference call with reporters. "It is not cosmetic. It is not elective. We are following our doctors' orders."
A spokesman for state House Majority Leader M. Kirkland Cox (R-Colonial Heights), the Republican Party's designee for House speaker in 2018 should the party remain in control of the chamber, accused Roem of abandoning her message of improving traffic in her district and "pivoting to a divisive social agenda."
"The House is going to focus on improving our economy, schools and roads," the spokesman, Parker Slaybaugh, said in a statement.
But Roem said her top priority still is relieving congestion on Route 28. She also said any insurance coverage effort would fall under the "quality of life" platform she campaigned on in her effort to defeat conservative incumbent Del. Robert G. Marshall (R).
Advocates say several states, including Virginia, have not updated their policies to match the Obama administration statute, in part because President Trump's White House may jettison it.
Virginia is among 37 states that do not have their own laws or regulations prohibiting insurers from denying coverage due to gender identity or sexual preference, according to the Movement Advancement Project, an LGBT research group. Maryland is also in that group.
The District implemented a ban against excluding coverage for transgender care in 2014.
"A lot of insurance plans specifically forbid the coverage of those services and treatment for reasons related to gender transition," said Sarah McBride, a transgender woman who is national press secretary for the Human Rights Campaign, "despite the fact that every major medical association has determined that that type of treatment is medically necessary."
Douglas Gray, executive director of the Virginia Association of Health Plans, an advocacy group for insurers, said he is unaware of insurers not complying with the federal statute. But Gray added that whether such coverage is rejected could depend on the type of treatment an individual is receiving and on the nature of their insurance plan.
A "self-insured" plan, where a patient's employer assumes all the financial risk of coverage, has rules dictated by the employer, not the insurance company, Gray said. Those plans also are regulated by the U.S. Labor Department, not the state, he said. "It really does depend on the example and where it comes from to ascertain why it has not been approved," Gray said.
The idea of improving health care for lesbian, gay, bisexual and transgender patients more generally in Virginia could receive a warmer reception in Richmond after significant gains by Democrats in Tuesday's elections. Three yet-to-be decided races will determine whether the party gains control of the state House for the first time since 2000.
Roem said she hopes to prevent situations similar to what she experienced after she began her physical gender transition in 2013, when she was denied coverage under her insurance plan for the cost of hormone medication prescribed by her doctor.
"I didn't even get to have a conversation with them," she recalled, saying she learned through an email that she would have to pay the full cost of the medicine.