They were presented with the following facts, and asked why the exclusion exists in the first place. They did not provide that answer, only going on to state that the exclusion (which was cleverly concealed in a mental health rider at the back of the employee guide behind a blank page behind the glossary) must be upheld because it's there.
The American Medical Association passed resolution 122, which specifies that Gender Reassignment Surgery is neither cosmetic nor experimental. In Tax Court vs. O'Dhonobain, the federal tax board came to the same conclusion. Also, it's been proven that given the rate of incidence, new federal legislation and the actual cost of the procedure, the cost is itself negligible.
The procedure is a reconstructive one in which all functionality is maintained and has been so for over 10 years. The World Professional Association for Transgender Health has a detailed standards of care for optimizing safe transition between genders.
SelectHealth was provided with specific instances of the self-mutilation, medical issues and suicide that happen when an individual can't afford surgery
The World Health Organization lists full medical transition as a cure for gender identity disorder. The Appeals Board was asked, "What is the cost of a human life?" They were challenged to determine the reasons the exclusions were created in the first place. They could not provide, nor did they seek to find an answer.
As the American Medical Association stated, the refusal to provide life-saving treatment for pennies on the dollar, given significant medical information and progress over the last 10 years that gender identity disorder is a congenital defect that sometimes requires full medical transition, is blatantly discriminatory.
Is it the right of a a medical insurance corporation to disregard medical progress in order to justify it's discrimination?
What's even worse is that SelectHealth does have a rider to drop the exclusion against "transsexual surgery," but they don't publicize it and they don't offer it to the Companies covered. They must magically know about the hidden exclusion, that there's a rider to drop the exclusion and that they can simply ask for it.
In a recent hearing, the committee stated in their denial letter, "The Committee understands your request but determined that the services are specifically excluded by the Plan. We regret this result could not be more favorable, but the Committee has a fiduciary obligation to consistently administer the Plan." Signed by Thomas B. Morgan, Chairman of the Board.
You can sign the petition here.
