Florida bans Medicaid use on gender-affirming treatments

Florida’s Agency for Health Care Administration (AHCA) has reportedly finalized rules that prevent health care providers from billing the state’s Medicaid program for gender-affirming medical treatments. 

Politico reported on Thursday that the agency added new language to Medicaid program rules stating that it would not cover services for the treatment of gender dysphoria, including sex reassignment surgery, puberty blockers or hormone therapies.

The outlet said the language will take effect on Aug. 21.

This action comes after the state’s AHCA announced in June that it had determined those services were “not consistent with generally accepted professional medical standards and are experimental and investigational with the potential for harmful long-term affects.”

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In a release detailing a “robust review of available medical evidence and the assessment of five medical experts,” the agency said that scientific studies supporting the treatments were “weak to very weak,” evidence showing benefits from hormone replacement therapies is “very weak,” that there were no randomized control trials on the effectiveness of “gender-affirming” care, there’s a lack of long-term follow-up studies after reassignment surgery and that studies did not show that the use of puberty blockers improves mental health.

“The agency will now initiate the rulemaking process regarding the Medicaid program’s coverage treatments for gender dysphoria,” it said then.

In April, guidance was released by the Florida Department of Health which recommended against hormone therapies, gender reassignment surgery and social transitioning. The department has accused the Department of Health and Human Services (HHS) of misleading the public.

Last Friday, the state’s medical board voted to start the rulemaking process. 

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While The Washington Post reported that Florida’s surgeon general, Joseph Ladapo, said that there was “clearly a level of risk with these procedures,” the American Academy of Pediatrics and the American Medical Association support gender-affirming care.

LGBTQIA+ and health rights groups – including Lambda Legal, Southern Legal Counsel, Florida Health Justice Project and National Health Law Program – said in a statement that the AHCA’s actions are “morally and legally wrong as well as medically and scientifically unsound.” 

“Ignoring thousands of public comments and expert testimony, Florida’s AHCA has finalized a rule that will deny Medicaid coverage for all medically necessary gender-affirming care for both youth and adults. This discriminatory and medically unsound rule will take effect on August 21, 2022, putting transgender people in jeopardy of losing access to critical gender-affirming health care services,” the groups wrote. 

A group of scientists and a law professor from Yale University have said in another report that the AHCA’s conclusions are “incorrect and scientifically unfounded,” as well as “crafted to serve a political agenda.” 

However, a spokesman for the Florida agency dismissed the academics’ report as “another example of the left-wing academia propaganda machine.”

The coalition vowed to fight the rules which the organizations said represent a “dangerous escalation in Gov. DeSantis’s political zeal to persecute LGBTQ+ people in Florida, and particularly transgender youth.”

Florida is joining other states, including Arizona, Missouri and Texas, in banning funds for the same purpose. 

The Associated Press contributed to this report.