Idaho Bans Gender-Affirming Care From Medicaid, State Insurance Coverage Moves Through Legislature
Idaho Bans Gender-Affirming Care From Medicaid, State Insurance Coverage Moves Through Legislature

BOISE (Idaho Capital Sun) – A bill to prohibit Idaho public funds from covering gender-affirming drugs and surgeries for Idaho adults and children is headed to Idaho Gov. Brad Little for final approval.

House Bill 668 would prohibit public funds from paying for gender-affirming drugs and surgeries. That would apply to Idaho residents covered by Medicaid and the Idaho State Insurance Plan, the Idaho Capital Sun previously reported.

The Idaho Senate passed the bill on a nearly party-line vote of 26-8 on Friday. All seven Senate Democrats opposed it. Sen. Abby Lee, R-Fruitland, was the only Senate Republican to vote against the bill.

The Idaho House of Representatives previously passed the legislation supported by 58 House Republicans and opposed by all 11 House Democrats.

Major medical groups say gender-affirming care is medically necessary and safe.

Idaho Medicaid largely covers low-income and disabled people and insures about 300,000 Idahoans. About 62,000 Idahoans are insured through state employees’ insurance policies, which are set to switch to a new insurer this summer.

A recent study found that gender nonconforming people are at a higher risk of being in a lower socioeconomic status. About 7,000 Idaho adults and 1,000 Idahoans age 13 and older are transgender, according to UCLA estimates.

Little expressed support for banning Medicaid coverage of gender-affirming care. In May 2023, he directed the Idaho Department of Health and Human Services to develop a policy to prohibit Medicaid coverage of gender-affirming treatment for adults and children.

Gender confirmation surgeries were not performed on minors in Idaho before last year’s child care ban was passed, the Idaho Capital Sun previously reported. The Idaho Department of Health and Human Services, which administers Medicaid, “has not covered any gender dysphoria surgeries for adults or youth,” a spokesman previously told the Idaho Capital Sun.

Sen. Ben Toews, R-Coeur d’Alene, told senators during debate Friday that the bill ensures that “taxpayer dollars are not used to pay for medically harmful treatments.”

“Responding to the world’s brokenness requires humility, compassion, and wisdom. We don’t have enough of these things on our own. And only through the power of our creator is healing truly possible. The answer to our suffering will not be invented, because integrity is given, not manufactured,” Toyus said.

Sen. Melissa Wintrow, D-Boise, called the bill discriminatory and part of a “family of bills that clearly violate the equal protection clause of the 14th Amendment.”

Idaho’s latest ban on gender confirmation builds on a previously passed bill that a judge temporarily blocked

Public officials or employees who willfully violate the bill could face charges for misuse of public funds.

If passed, House Bill 668 would still allow surgical procedures and drugs used in gender confirmation care to use public funds in certain cases, such as when necessary for health. But the bill excludes it in order to “affirm an individual’s perception” of their gender, the legislation says.

“A surgical operation or medical intervention is never necessary for the health of the minor or adult on whom it is performed if it is for the purpose of altering the individual’s appearance in order to confirm the individual’s perception of his gender in a way that is inconsistent with with the individual’s biological sex,” the bill says.

House Bill 668 relies on a definition of gender-affirming drugs and surgeries created in Idaho law by last year’s House Bill 71. Implementation of this law was blocked during litigation that was appealed to the US Supreme Court.

House Bill 668 allows the following exceptions to the ban:

  • When a surgical operation or medical intervention is “necessary for the health of the person on whom it is performed”.
  • To treat infections, injuries, or disorders “caused or aggravated by … gender transition procedures.”
  • And when “performed in accordance with the good faith medical decision of a parent or guardian of a child or adult born with a medically demonstrable genetic disorder of sexual development.”

If passed, House Bill 668 would take effect on July 1.

House Bill 71, which is temporarily blocked, would have banned sex-affirming drugs and surgeries for every child in Idaho, but not all gender-affirming care, the Idaho Capital Sun previously reported. But implementation of the law has been temporarily blocked as a lawsuit challenging the legislation makes its way through the courts.

Government property, facilities or buildings could not be used “to perform surgical operations or medical interventions” in that previous law.

Physicians or health professionals employed by state, county, or local governments may not provide these services “in the course and scope of (public) employment.”

The bill would ban any gender-affirming drugs and surgeries “for the purpose of altering an individual’s physical appearance to confirm the individual’s perception of their gender in a manner inconsistent with the individual’s biological sex.”

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