OVERLAND PARK, KS - Blue Cross Blue Shield of Kansas has changed its policy that forced people seeking gender-affirming surgery to legally change their name before the insurance giant would cover the surgery.
The new policy was the result of advocacy by the ACLU of Kansas and the Transgender Legal Defense and Education Fund, on behalf of Charley Osman, a transgender man seeking two gender-affirming surgeries in the Kansas City area through his BCBS of Kansas policy. Osman sought pre-authorization for the surgeries in June, but BCBS denied coverage.
The insurance company that covers more than one million Kansans announced the new policy (today) on its website https://www.bcbsks.com/medical-policies/sex-reassignment-surgery-2021-12-08.
“I’m pretty sure I’m not the first person to go through this, but I want to be sure I’m the last,” said Osman. “This is an incredibly expensive surgery, and for a long time I was afraid I wouldn’t be able to have it. I’m very glad Blue Cross Blue Shield changed their policies so that no one else has to go through what I did.”
Though multiple medical providers agreed Osman’s surgery was medically necessary, BCBS denied him coverage because Osman had not legally changed his name from the one assigned him at birth. In August, the ACLU of Kansas sent a letter to BCBS on Osman’s behalf stating that this policy requirement, among others, was outdated, inconsistent with medical standards, discriminatory, and illegal.
“We’re glad that BCBS of Kansas stepped up to change this antiquated policy requirement. This is an important first step toward ensuring that Blue Cross/Blue Shield of Kansas provides care that is inclusive, non-discriminatory, and rooted in clinical standards,” said Sharon Brett, legal director for the ACLU of Kansas. “We a look forward to continuing to work with BCBS of Kansas to review other aspects of the policy to ensure that it aligns with their stated values,” added Josh Pierson, ACLU of Kansas Senior Staff Attorney.
“Nationwide, insurance carriers cover gender-affirming care for transgender individuals, consistent with federal and state law. This policy change is a step in the right direction,” said Ezra Cukor, Senior Staff Attorney with TLDEF. Many transgender individuals may not want to change their name, and legal name changes can be an expensive and arduous process. Importantly, a legal name change has no relation to medical necessity.
Kansas LGBTQ advocacy groups hailed the policy shift and were cautiously optimistic about more policy changes for people seeking this kind of healthcare coverage from BCBS.
“Transgender Kansans have struggled for years overcoming disparities in access to health care and insurance. Today’s news signals another step forward for LGBTQ Kansans in on our long road to full equality,” said Thomas Witt, executive director of Equality Kansas, the state’s leading LGBTQ advocacy group. “We are pleased that BCBS of Kansas has taken this step, and are grateful to the ACLU of Kansas and TLDEF for their tireless work on our community’s behalf.”
As a result of ACLU of Kansas and TLDEF’s advocacy, Osman will undergo his medically necessary surgeries before the end of the year. An independent medical reviewer that considered Osman’s claim appeal determined that the surgeries were medically necessary for Osman, and that BCBSKS’s stated reason for denying coverage had no basis in the literature. Following this determination, the ACLU and TLDEF engaged in additional advocacy to change the company’s policy.
The ACLU successfully reasoned that the BCBS policy was inconsistent with the World Professional Association for Transgender Health (WPATH)’s Standards of Care. The medical profession, courts, and USDOJ widely recognize the WPATH Standards of Care as the standard of care for treatment of gender dysphoria.
Obtaining coverage for Osman and removing the name change requirement in BCBS policy was a milestone, however, not the final goal.
The ACLU of Kansas and TLDEF are still advocating for BCBS to bring its policies into alignment with its members’ civil rights and current clinical practice.
For example, Brett said a number of medically necessary procedures for transgender individuals were categorically excluded from coverage without justification.
“We continued to advocate directly to Blue Cross Blue Shield of Kansas for reforms to the policy to ensure other subscribers were not wrongfully denied medically necessary care.”
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About the ACLU of Kansas: The ACLU of Kansas is the statewide affiliate of the national American Civil Liberties Union. The ACLU of Kansas is dedicated to preserving and advancing the civil rights and legal freedoms guaranteed by the United States Constitution and the Bill of Rights. For more information, visit our website at www.aclukansas.org.
