On Friday, March 15, the Department of Insurance, Securities, and Banking (DISB) issued a bulletin that prohibits discrimination based on gender identity or expression by insurance companies writing health insurance in the District of Columbia. The bulletin clarifies the District Official Code § 31-2231.11(c), the District’s Unfair Insurance Trade Practices Act, which makes it illegal to refuse to insure, refuse to continue insuring, or limit the insurance coverage to an individual on the basis of gender identity or expression and a host of other areas. The DISB bulletin makes clear that discriminatory language barring certain services to transgender individuals is not enforceable. Furthermore, health insurance companies with this type of discriminatory language in their policy have 90 days from the issuance of the bulletin to update their policy forms.
In practical terms, this means that health insurance policies and the practices of health insurance companies covering individuals or groups in the District cannot refuse health coverage to individuals who are transgender. Prior to this new directive being issued, numerous health insurance companies operating in the District had explicit policies that excluded transgender women and men from many of the same services that they provided to their non-transgender patients. Some of the services denied to transgender individuals, but approved for other patients included: mastectomies for breast cancer; hormone replacement therapy; and high blood pressure medications.
Last month, the Mayor’s Office of Gay, Lesbian, Bisexual, and Transgender (GLBT) Affairs informed DISB of discriminatory language in the policies of several health insurance providers (including CareFirst, the District government’s own Essential Health Benefit) and the two offices collaborated to redress this issue quickly. With the issuance of this directive, the District becomes one of the first places to prohibit discrimination based on gender identity and expression in health care and insurance. Only California and Oregon offer similar protections.