An Oregon Senate Bill revision: Insurance for he, she, zhe

“We all know someone who has been denied medically necessary care by an insurance company working to protect its bottom line,” Basic Rights Oregon stated in its Jan. 4 newsletter. In fact, if we’ve watched TNT’s “Leverage,” we might infer that all insurance companies are like IYS: terrible and evil — unless the TV lied to us about that, too.  
Regardless, the main goal of a for-profit insurance company is to protect the bottom line: to make money, not to give money away.  
Because of the “cover your ass” policies of many insurance companies, citizens are denied medical coverage if they don’t meet specific parameters. One such parameter is that they are “cisgendered” — a term that means a person identifies as the sex he or she was born as. Transitioning or transgender citizens are often denied eligibility for insurance policies before the application process is even completed.

According to the Basic Rights Oregon newsletter, “many transgender Oregonians are denied the ability to purchase health insurance or are denied coverage for basic, medically necessary care solely because they are transgender.”  
However, parts of the Patient Protection and Affordable Care Act, which will come into effect in 2014, may have prompted the recent revision seen in the Oregon Insurance Division. According to the Henry J. Kaiser Family Foundation Health Reform Source FAQ page, the healthcare reform will require most citizens — those whose health insurance costs would be less than 8 percent of their total income, and who make enough to qualify for the need to pay federal taxes — to either purchase health insurance or pay a fine; the fine will start as 1 percent of annual income in 2014, though it will increase in the following years.

The Oregon Insurance Division Bulletin applies the revised 2007 Oregon Senate Bill 2 to gender identity issues in the transaction and regulation of insurance in Oregon.

To sum up the revised version of the 2007 bill, the non-discrimination wording of the bill has been amended to include discrimination against sexual orientation by redefining the term to mean “an individual’s actual or perceived heterosexuality, homosexuality, bisexuality or gender identity, regardless of whether the individual’s gender identity, appearance, expression or behavior differs from that traditionally associated with the individual’s sex at birth.” (ORS 174.100)
Another factor in the recent revision may have been a 2011 civil case. According to a report by Nigel Duara of KVAL, Lambda Legal, a civil rights organization focusing on the rights of the LGBTQ community, sued the state of Oregon on behalf of Alec Esquival, an Oregon state court of appeals clerk, for refusing to cover a doctor-recommended hysterectomy during Esquival’s transition from female to male, a process that began in 2001. The hysterectomy was not covered under Esquival’s insurance policy due to the underlying reason it was needed — Esquival’s gender identity disorder. The surgery would have been covered if not for Esquival’s GID, according to a statement Esquival’s attorney made to KVAL. Without the surgery, Esquivel is at increased risk for uterine and ovarian cancer.

The reason behind Basic Rights Oregon’s Jan. 4 newsletter was celebration that health insurers may no longer “exclude transgender patients from coverage,” and “must provide coverage and cannot deny coverage of treatments for transgender policy holders if the same treatments are covered for other policy holders.” Health insurers must also “not deny treatment on the basis of a policy holder’s actual or perceived gender,” and that “the statewide mandate for coverage of mental health services must apply to transgender patients.”

Essentially, all this means is transgender or diagnosed GID patients will qualify for health insurance.  
A whole subsection of people will no longer be automatically slated for that fine in 2014 when that part of the Patient Protection and Affordable Care Act come into effect.


Irene Drage is a senior in English. The opinions expressed in her columns do not necessarily represent those of The Daily Barometer staff. Drage can be reached at forum@dailybarometer.com.