Idaho House Debates Public Funding Ban on Transgender Care
TL/DR –
The Idaho House is considering a bill that would ban public funds from covering gender-affirming medications and surgeries for adults and children. The Idaho House Judiciary and Rules Committee has advanced the bill, House Bill 668, to the House floor. The bill would specifically apply to Idaho Medicaid, impacting around 300,000 Idahoans, but its impact on health insurance provided to Idaho state employees and their family members, which covers around 62,000 Idahoans, is still unclear.
Idaho Bill Aims to Outlaw Public Funding for Gender-Affirming Care
The Idaho House is considering House Bill 668, seeking to prevent public funds from being used for gender-affirming medications and surgeries for adults and children. The bill builds on Idaho’s 2023 law prohibiting such treatments for minors.
The proposed legislation is set to impact Idaho Medicaid, which insures approximately 300,000 Idaho residents, primarily the low-income and disabled. The bill’s effect on insurance provided to Idaho state employees and their dependents, who number around 62,000 and are expected to change insurance providers soon, remains unclear.
According to Rep. Julianne Young, the bill is not explicitly about state insurance, but the usage of public funds. The Idaho House Judiciary and Rules Committee has voted to advance the bill, which Young co-sponsored with Rep. Bruce Skaug, to the House floor.
The bill stipulates that Idaho Medicaid cannot reimburse gender-affirming treatment banned under an existing Idaho law, state facilities cannot provide those services, and healthcare professionals employed by the government cannot provide those services as part of their public employment.
The bill forbids any gender-affirming care intended to alter an individual’s appearance to match their perceived sex when it conflicts with their biological sex. A recent study found that gender non-conforming individuals are more likely to be of lower socio-economic status. The University of California-Los Angeles estimates that about 8,000 Idaho residents are transgender.
Public Opposition and Medical Necessity of Gender-Affirming Care
Despite the medical necessity and safety of gender-affirming care as endorsed by major medical groups, the bill faced substantial opposition, especially from three Idaho health professionals and individuals who receive gender-affirming care. Supporters of the bill found the use of public funds for such care objectionable on religious or other grounds and questioned the treatment’s effectiveness.
For instance, South Carolina urologist Dr. Julius Teague critiqued the lack of robust clinical evidence for such treatments. In contrast, Boise doctor Marvin Alviso testified that none of his over 400 patients regretted their hormone treatments. AlexaLynne Fill, a transgender woman, and Merrick Collins, a transgender man, spoke of the positive impact of gender-affirming care on their lives and its importance for their health and social functioning.
The proposed law specifies conditions under which surgical procedures and medications used in gender-affirming care can still be publicly funded. However, it excludes those intended to affirm an individual’s perceived sex when it contradicts their biological sex. Currently, seven states prohibit Medicaid from covering gender-affirming care, according to a 2022 UCLA report.
Exceptions in the Proposed Law
The bill outlines exceptions, allowing public funding for treatment that is “necessary to the health of the person on whom it is performed”, to treat conditions “caused or exacerbated by … gender transition procedures,” and for individuals with a “medically verifiable genetic disorder of sex development.” If passed, the bill will take effect on July 1, 2024.
In May 2023, Idaho Gov. Brad Little had directed the Idaho Department of Health and Welfare to develop a policy banning gender-affirming care for both adults and children. The policy is currently under development, with the department clarifying that it has not covered any surgeries for gender dysphoria for adults or youth.
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