Northam’s budget would guarantee transgender health services for Medicaid enrollees

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Published: Jan. 4, 2021 at 7:36 AM EST
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Tucked away in the 750-page revised budget Gov. Ralph Northam presented last month is a single line that his administration says would guarantee that transgender enrollees in Virginia’s expanded Medicaid program have access to gender-affirming care.

“This is an important equity issue and a critical part of making our commonwealth welcoming and inclusive of all,” Northam’s spokeswoman, Alena Yarmosky, said in an email.

If the General Assembly agrees to the language, Virginia would become at least the 19th state to explicitly affirm that transgender care is covered by its Medicaid program, according to statistics gathered last year by UCLA School of Law.

Another 12 states have adopted laws or regulations expressly banning coverage of gender-affirming care for transgender Medicaid enrollees, UCLA’s review found. (At least two of those states, West Virginia and Alaska, are currently facing lawsuits challenging the policies. )

Virginia is one of 20 states with no express policy on the issue.

Leaders of the state’s Medicaid program said the care, which can range from counseling to hormonal therapy and gender reassignment surgeries, is already covered by all six of the health insurance providers that administer Virginia’s Medicaid program.

But they said making the state’s policy on the issue clear and unambiguous is an important step forward.

“Transgender individuals face a tremendous amount of stigma in society,” said Dr. Chethan Bachireddy, the chief medical officer overseeing Virginia’s Medicaid program. “An affirmative policy not only says, ‘This is what we’re doing,’ in a way that’s explicit and public. But it’s also helping to reduce some of the stigmas that might be associated with seeking care related to gender dysphoria.”

There are an estimated 34,500 transgender people living in Virginia, 2,000 of whom are on Medicaid, according to UCLA, though the researchers and Bachireddy cautioned that those numbers likely undercount the population of transgender adults the state is serving because not all are comfortable openly sharing the information.


The Virginia Mercury is a new, nonpartisan, nonprofit news organization covering Virginia government and policy.

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