HEALTHCARE
plan exclusion.”
The employee health plan through Tri-county Schools Insurance Group states that its care does not cover “charges for services, supplies or treatment for transsexualism, gender dysphoria or sexual reassignment or change, including medications, implants, hormone therapy, surgery, medical or psychiatric treatment.”
When Condrey first learned that his policy wouldn’t cover his daughter’s medical care back in 2017, the family sought a secondary insurance policy through the mother’s employer, but when her employment status changed, the family had to begin paying directly out of pocket.
The family isn’t just paying for transition-related treatment, but even for doctor’s visits related to issues other than gender
dysphoria, because gender dysphoria is always listed for Condrey’s daughter as an ongoing secondary or tertiary diagnosis. The family has spent more than $7,000 for health care costs since the situation began.
He brought it to the attention of his employer in 2017, he said, but his concerns were largely ignored.
He said it was hard to get any sort of response from both the college district and the insurance company regarding why he was denied – the only response he received was from a third-party administrator of the health plan in November 2017 stating that the insurance company was not subject to the Affordable Care Act’s non-discrimination rule.
Douglas Houston, chancellor of the Yuba Community College District, said he was first made aware of the issue earlier this calendar year, and once he became apprised of the situation,
he made a formal request for the insurance company to remove the exclusion.
“We requested TCSIG remove this exclusion and amend its plans, and they are planning to do so,” Houston said.
The insurance group has a board meeting later this week with an agenda item dedicated to the topic. Houston said he fully expects the board to make the changes as requested.
Condrey said he’s hopeful that the college and insurance group will follow the law and change the policy, but he remains skeptical.
“I have coworkers at Yuba College, either they or their families are impacted by this policy, they just aren’t in the same place as us or maybe don’t have the time to complain. My hope is they’ll make this right, and part of that is finding out who has slipped through the cracks here,” Condrey said. “I want them to have a strategy for determining if other families have been impacted or hurt by this,
for those that haven’t been able to voice their concerns. I think there is a lot they can do to correct this.”
Mathew Evans, director and plan administrator for the Tri-county Schools Insurance Group, could not be reached for comment on Tuesday.
Policy’s legality
In a letter sent to both Houston and Evans this week, Elizabeth Gill, senior staff attorney with the ACLU Foundation of Northern California, said it is illegal for both employers and public entities in California to discriminate against transgender people, and that a health care plan that explicitly excludes medically-necessary care for transgender people does just that.
In addition to California law explicitly recognizing that health care coverage exclusions related to gender-affirming care are discrimination based on gender identity, she said, it also violated federal employment non-discrimination law and constitutional equal protection.
“It is again astonishing to us that in 2019 a California community college would have an exclusion for gender-affirming care in its employee health plan – and apparently defend the exclusion as both legal and appropriate,” Gill said in the letter. “…For the reasons stated above, YCCD and TCSIC must take immediate action to remove the exclusion on gender-affirming care from its employee health care plan, as well as to compensate its employees who were harmed by the exclusion.”
The Tri-county Schools Insurance Group Executive Committee will meet on Friday to discuss “consideration and possible approval of plan amendment to allow for transgender benefits and related incentives.” The public meeting starts at 9:30 a.m. and will be in the Beckwourth Room at Yuba County One Stop – 1114 Yuba Street, Marysville.