Pritzker: Illinois’ Medicaid program will cover sex reassignment surgery

By Greg Bishop
Illinois News Network

SPRINGFIELD — Illinois Gov. J.B. Pritzker said the state’s Medicaid program will use state and federal funds to cover sex reassignment surgery, but the governor’s office hasn’t said how much the policy change could cost.

Pritzker’s administration said the state’s Medicaid program “will begin covering gender-affirming surgeries for members under new policies being established.”

The proposed rule, the administration said, would allow Medicaid members 21 and older diagnosed with gender dysphoria to be eligible for genital and breast-related surgeries.

About 1,400 of the state’s 3.1 million Medicaid members are diagnosed with gender dysphoria, according to a news release from the governor’s office. Last year, about 2,500 prescriptions for hormone therapy were covered.

Coverage could be available starting this summer after a public comment period.

“Healthcare is a right, not a privilege, and I’m committed to ensuring our LGBTQ community and all Illinoisans have access to that right,” Pritzker said in a statement Friday.

John Knight, LGBT and HIV Project director for ACLU Illinois, praised the decision.

“We welcome Gov. Pritzker’s announcement that Illinois will cover gender affirming surgery under its Medicaid program,” ACLU of Illinois’ John Knight said in a statement. “This is a crucial step to respond to the health care needs of all Illinois residents, including those who are transgender.”

“By putting an end to this outdated exclusion on gender affirming surgery, Illinois now joins a long and growing list of states providing coverage for this critical, lifesaving health care,” Knight said. “We applaud the Governor for making this important step forward.”

State Rep. Allen Skillicorn, R-East Dundee, said the last thing Illinois needs is an expansion of Medicaid, “especially one that defies biology.”

“I’m speechless that the governor would do this not through the legislative branch but simply through a rule change,” Skillicorn said.

Pritzker said in a statement that the move will be cost-effective because it would help avoid long-term health problems such as depression and suicide.

“With continued attacks coming from Washington, this administration will always stand with our transgender community and their right to lead safe and healthy lives,” Pritzker said.

The administration said the U.S. Department of Health and Human Services in 2016 set rules to require access to gender transition services, and that 17 states and the District of Columbia allow for such surgeries.

The governor’s office did not include a projected cost for the proposed rule change.

The change would affect HealthChoice Illinois, the state’s managed care program, and people receiving care through fee-for-service.

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