Jenna Sehl, a transgender woman, has health insurance coverage with Priority Health, which participates in the health insurance marketplace under the federal Patient Protection and Affordable Care Act (ACA). Although the ACA prohibits discrimination on the basis of sex and gender identity, Priority Health is one of several health insurance companies with a policy of not covering any transgender health-related services, including hormone replacement therapy and gender confirmation surgery, even when a physician determines that they are medically necessary treatments for a diagnosis of gender dysphoria.
In April 2015 the ACLU of Michigan filed a complaint with the Michigan Department of Insurance and Financial Services (DIFS), challenging Priority Health’s policy as discriminatory, but DIFS upheld the denial of coverage. In July 2015 we filed a complaint with the Office for Civil Rights of the United States Department of Health and Human Services (HHS), alleging that Priority Health’s denial of coverage is unlawful discrimination in violation of federal regulations governing the ACA. We have also filed discrimination complaints with HHS on behalf of several other transgender persons who have been denied coverage by their insurance agencies. The complaints remain under investigation and review.
(ACLU Attorney Jay Kaplan.)
View the full 2014-2015 Legal Docket.