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Georgia Can No Longer Deny Coverage for Transgender Care
press release.Two of the plaintiffs — Micha Rich, a staff accountant at the Georgia Department of Audits and Accounts, and Benjamin Johnson, a media clerk at an elementary school in Bibb County, Georgia — are transgender men who have been diagnosed with gender dysphoria and were advised to pursue social and medical transition to treat their dysphoria.The third plaintiff, referred to by the pseudonym “Jane Doe,” is an employee of the state’s Division of Family and Children’s Services, whose adult transgender son, “John,” gets his insurance coverage through his mother’s plan.In all three instances, the plaintiffs were denied coverage for gender confirmation surgery. Rich and John Doe were also denied coverage for hormone therapy — even though such treatments are offered to non-transgender patients if recommended by their doctors — because they would assist in a gender transition, violating the state employee insurance plan’s prohibitions on coverage for transition-related treatments.As a result of the denials of coverage, all three trans individuals had to forego surgery for a significant period — in Rich’s case, two full years.Rich and Doe ultimately had to pay out of pocket to cover the cost of their surgical and hormonal treatments, with Rich being forced to declare bankruptcy a few months later due to the financial strains placed on him.Johnson was able to have his surgery covered by switching to a non-discriminatory Marketplace plan, which he had to pay for out of his own pocket.Under the terms of the settlement, the members of the State Health Benefit Plan, including state employees and their dependents, will now be able to obtain coverage for gender-affirming treatments, effective immediately.
