Health insurers would struggle to cover transgender issues: Styles
Health insurers would struggle to provide cover for transgender-specific care, the Finance and Expenditure Select Committee has been told.
Wednesday, July 8th 2020, 9:30PM 
2 Comments
Elizabeth Poucher brought a petition asking for the House to conduct an inquiry into the availability of health insurance for transgender people's care related to transitioning.
She said that transgender people were often unable to get cover for things such as breast cancer, which were affected by hormone treatment, although a male-to-female transgender person was no more at risk than a cisgender woman. Poucher said that while people could sometimes get cover for other pre-existing conditions if they were willing to pay a premium loading, that was not the case for transgender people.
Health Funds Association chief executive Roger Styles said insurers had to be able to offer an affordable product that was appealing to people to voluntarily purchase.
Transgender care was excluded because of the high cost of the transition process, he said, and the risk of adverse selection. People who thought they might transition would take out cover that would pay for it, loading insurers with extra risk.
He said insurers did not agree with Poucher that this was discrimination.
If it were to work, it would need to be offered as a module – similar to non-Pharmac drugs – he said, which would be expensive for customers, or by insurers asking questions at the underwriting stage. But that process could end up excluding the people who would need it, he said. "Neither would bring the benefit this petitioner is seeking."
Poucher said the proportion of transgender people in the population was not high enough to pose a financial problem to insurance. She said the current situation made it hard for people to get basic health needs met. "Paying for [gender reassignment] surgery would be great but I'm just asking for us to be able to get cover full stop."
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Comments from our readers
They're not even in the same sport, let alone ball park.
It's certainly not viable for any health insurer to include cover for a mental health condition that has a high probability of an expensive surgical claim, as a default outcome.
A little more education on the difference between insurance and welfare may be helpful here.
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Which is directly excluded under all but a few policies on the market. And even then those that offer cover, the contributions are focused on grief or EAP style support than chronic condition support.
More the point to gain traction on improving the insurance response we need to see a better public health response, and given the nature of the subject that is going to be contentious at best.
With the provision of support from public health where the cost and selection risk to the insurer can somewhat be mitigated, there is a greater chance of the insurers offering coverage.
The wider public doesn't seem to understand that there is a direct and tangible cost to the large numbers paid by insurers, and this doesn't appear out of thin air. It has to be accounted for.
The general public needs to better understand that insurance is the transfer of risk for a premium, where the entity taking on that risk gets to set the terms, conditions, and price of that risk.
And we can complain as much as we like about that, and I have loudly in some cases, but there is no compelling an insurer to commit suicide with policy structures that impact their financial stability. Insurers choosing to do so on their own accord is a completely different matter.
Long story short, I would love to see more support in this area, and mental health, from medical insurers. At the same time I'm realistic that it will be a long time coming. Though hopefully, it will be available in the future.