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Mon Nov 23, 2020, 02:49 PM

Lambda Legal Sues Blue Cross Blue Shield of Illinois Over Anti-Transgender Policy

Source: Lambda Legal

NOVEMBER 23, 2020

Today, Lambda Legal and Sirianni Youtz Spoonemore Hamburger PLLC filed a federal lawsuit challenging Blue Cross Blue Shield of Illinois’s (“BCBSIL”) administration of a blanket exclusion of gender-affirming care in an employer-provided health insurance plan provided by Catholic Health Initiatives Franciscan. The lawsuit was filed in the United States District Court for the Western District of Washington in Tacoma on behalf of a 15-year-old transgender boy, “C.P.,” and his parents, and argues the exclusion is in direct violation of the nondiscrimination provisions under Section 1557 of the Affordable Care Act.

“My son needs the medical care that will allow him to live, be healthy, and to thrive. However, because he is transgender, I have to fight and jump through hoops for him to have access to the care that he needs, is legally entitled to and that he deserves,” said Pattie Pritchard, C.P.’s mother and the primary beneficiary on the employer-provided health benefit plan that BCBSIL administers. “This denial also sends a message to my son and all transgender people, that their health care needs aren’t real or they’re not worthy of care. I won’t accept that.”

BCBSIL is a “covered health entity” under the ACA, which means BCBSIL cannot, and it has represented that it does not, discriminate on the basis of race, national origin, sex, age and disability. The ACA’s Section 1557, which BCBSIL agrees it must abide by, prohibits discrimination on the basis of sex and gender identity, such as in the provision of transition-related care. As such, BCBSIL cannot administer the discriminatory terms of the health plan provided by Pattie Pritchard’s employer—St. Michael Medical Center in Bremerton, Washington, which is part of the Catholic Health Initiatives Franciscan Health System, now known as CommonSpirit Health.

“The law is clear, Blue Cross Blue Shield of Illinois cannot deny C.P., or any transgender person, the health care that he needs,” said Omar Gonzalez-Pagan, Senior Attorney and Health Care Strategist for Lambda Legal. “Section 1557 of the ACA expressly prohibits categorical bans on gender-affirming care because it is discrimination on the basis of sex, plain and simple. BCBSIL cannot adopt or administer discriminatory terms on behalf of others. As a covered entity under the ACA, BCBSIL has to play by the same rules as everyone else, no exceptions.”


More at link: https://www.lambdalegal.org/blog/20201123_lawsuit-bcbs-transgender-policy

I thought insurance companies couldn't deny coverage to anyone based on gender issues. It seems flat-out unconstitutional, on its face.


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Reply Lambda Legal Sues Blue Cross Blue Shield of Illinois Over Anti-Transgender Policy (Original post)
Mike 03 Nov 2020 OP
OldBaldy1701E Nov 2020 #1

Response to Mike 03 (Original post)

Mon Nov 23, 2020, 04:14 PM

1. And yet...

this kind of thing happens all the time. Face it, insurance company executives would toss their own mothers under a bus as long as the payout could be avoided. Yet, we have no other options but to use insurance entities... well, we could just pay the exorbitant prices I suppose. I still await any other option. The fact that we can choose to be metaphorically raped by insurance, or raped by an out of control medical pricing board is not exactly having options, now is it?

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