Variability in Medicaid Coverage for Gender-affirming Surgeries Across US States

被引:7
作者
Wu, Catherine A. [1 ]
Ho, Isabella [2 ]
Minasian, Alexandra [3 ]
Keuroghlian, Alex S. [4 ,5 ]
O'Brien-Coon, Devin [4 ,6 ]
Ranganathan, Kavitha [4 ,6 ,7 ]
机构
[1] Univ Calif Irvine, Dept Plast Surg, Orange, CA USA
[2] Boston Univ, Boston, MA USA
[3] Massachusetts Gen Hosp, Dept Cardiol, Boston, MA USA
[4] Harvard Med Sch, Boston, MA USA
[5] Massachusetts Gen Hosp, Dept Psychiat, Boston, MA USA
[6] Brigham & Womens Hosp, Div Plast & Reconstruct Surg, Boston, MA 02115 USA
[7] Brigham & Womens Hosp, Ctr Surg & Publ Hlth, Boston, MA 02115 USA
关键词
coverage; gender-affirming surgery; Medicaid; state-by-state review; United States; FACIAL FEMINIZATION SURGERY; TRANSGENDER;
D O I
10.1097/SLA.0000000000005974
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective:To describe the current Medicaid coverage landscape for gender-affirming surgery across the United States at the procedure level and identify factors associated with coverage.Background:Medicaid coverage for gender-affirming surgery differs by state, despite a federal ban on gender identity-based discrimination in health insurance. States that cover gender-affirming surgery also differ in which procedures are included in Medicaid coverage, leading to confusion among patients and clinicians.Methods:State Medicaid policies in 2021 for gender-affirming surgery were queried for each of the 50 states and the District of Columbia (D.C.). State partisanship, state-level Medicaid protections, and coverage of gender-affirming procedures in 2021 were recorded. The linear correlation between electorate partisanship and total procedures covered was assessed. Pairwise t tests were used to compare coverage based on state partisanship and the presence or absence of state-level Medicaid protections.Results:Medicaid coverage for gender-affirming surgery was covered in 30 states and Washington, D.C. The most commonly covered procedures were genital surgeries and mastectomy (n = 31), followed by breast augmentation (n = 21), facial feminization (n = 12), and voice modification surgery (n = 4). More procedures were covered in Democrat-controlled or leaning states, as well as in states with explicit protections for gender-affirming care in Medicaid coverage.Conclusions:Medicaid coverage for gender-affirming surgery is patchwork across the United States and is especially poor for facial and voice surgeries. Our study provides a convenient reference for patients and surgeons detailing which gender-affirming surgical procedures are covered by Medicaid within each state.
引用
收藏
页码:542 / 548
页数:7
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