Gender transition insurance coverage could be required under new bill

ST. PAUL, Minn. (FOX 9) - Insurance companies covering services for people seeking to change their gender could become required under Minnesota law if a proposal being considered by lawmakers is approved.

Authored by Rep. Leigh Finke (DFL-St. Paul), legislators are discussing a bill that would prohibit a health plan that covers physical or mental health services from excluding coverage for "medically necessary gender-affirming care, or requiring gender-affirming treatments." In part, the bill defines "medically necessary care" as "health care services appropriate… to the enrollee’s diagnosis or condition; diagnostic testing; and preventive services."

"This clarifies statutory coverage of gender-affirming care into law," Rep. Finke told the House Health Finance and Policy Committee on Thursday. "We want to make sure that all gaps are closed."

Several testifiers spoke in support of the proposal, expressing the belief that health care coverage by insurance companies should be available to all communities under Minnesota law. In total, the bill also has 26 different co-sponsors.

"Minnesota has in large part been providing this care already, and we believe it should be codified into law so that there is clarity for people seeking best practice healthcare wherever they go," said Kat Rohn, executive director with OutFront Minnesota.

But concerns with the proposal centered around the safety of transitioning minors, and the need for more supporting research before mandating coverage.

"Based on the language of this policy, one might assume that the medical community globally has consensus on this issue, but that’s not the case," said Rebecca Delahunt, director of public policy with the Minnesota Family Council.

Delahunt cited several studies casting doubt on long-term effects of gender transitions, and countries that were claimed to be, "shifting toward a less medicalized approach," such as the United Kingdom and Finland.

"There is a lack of consensus in the medical community about how to treat this," she said.

Failed changes

Amendments offered by committee members sought to change the legislation, adding protections that both widened coverage and increased the age limit on certain services.

One proposal offered by Rep. Danny Nadeau (R-Rogers) would have clarified the term "full coverage" to include someone de-transitioning from a gender change as well.

Under his version, coverage for "medically necessary gender-affirming care" would include, "coverage for the reversal of a prior gender-affirming procedure or treatment."

According to Rep. Nadeau, the move sought to be inclusive to everyone on the gender-fluidity spectrum.

However, the proposal failed to gain committee approval by an 8-11 vote.

"I’m shocked that we would not include this language," said Rep. Duane Quam (R-Byron).

Another amendment offered by Rep. Nadeau would have created an age limit of 21 years old for surgical and medical procedures associated with a gender-affirming transition.

"I’m trying to protect adolescents by focusing on treatment and care through counseling… But preserving medical and surgical interventions until after the age of 21," said Rep. Nadeau.

However, Rep. Finke took issue with adding any further restrictions, saying, "We need to provide medically necessary care to those who need it, when they need it."

The amendment also failed to gain approval.

Heated discussion

Final discussion before the bill was laid over for possible inclusion in a larger collection of bills, called an omnibus bill, saw conversation become tense as lawmakers' voices were raised when expressing concerns over an alleged lack of scientific research behind the proposal.

"Can the author tell me what specific scientific studies you used to refine the language of this bill?" Rep. Quam asked.

"Every major medical organization recognizes that gender-affirming care is necessary life-affirming healthcare and should be provided," Rep. Finke responded. "Gender-affirming care has always existed. It’s not new. The idea that you are learning about who we are is happening not because of a decision we made, it is a decision that was made by conservatives to politicize us for political gain… They threw everything at the wall, and trans kids stuck. The attack is not scientific, it is political, and we can show you the receipts."

Rep. Quam then accused Rep. Finke of "not answering the question," and "launching into a political diatribe."

On several occasions, Rep. Quam referred to Rep. Linke as "he" despite having been corrected, and told to refrain from doing so on future reference.

Rep. Finke became the first transgender lawmaker in the Minnesota House after she won the Minnesota House District 66A seat in November 2022.

In another stern exchange of words, Rep. Anne Neu Brindley (R-North Branch) took issue with Rep. Finke alleging any opposition to the proposal was political.

"Whether trans people should have access to care is not a policy I’m willing to disagree about," Rep. Finke said. "We’re just trying to live our lives. I hate this. We shouldn’t have to do this."