Just how common is it for Medicaid to reimburse for gender-affirming care?
Agency for Health Care Administration (AHCA) data shows not very.
AHCA data provided to Florida Politics shows the number of adults and children receiving gender-affirming care and the care Medicaid reimbursed for Fiscal Year (FY) 2017-18 through FY 2021-22.
Medicaid does not provide any benefits to children without parental consent. Children are defined as beneficiaries under 21 years of age, meaning the children category could include information on 18,19 or 20-year-old beneficiaries.
Data show that 12 children and 13 adults underwent surgical procedures in FY 2021-22 that Medicaid reimbursed. The most common procedure for both groups was a simple mastectomy, with three children and six adults undergoing the process sometime between July 1, 2021, and June 30, 2022.
Medicaid covered the removal of the testis for two children and two adults and the amputation of a penis for one adult and one child. The safety net program for the poor, elderly and disabled also paid for the surgical construction of two artificial vaginas, one for a child and one for an adult.
Doctors performed 15 gender-affirming surgical procedures on 12 children, in addition to 19 on adults in FY 2021-22.
AHCA supplied data that show 1,775 prescriptions for 15 minutes of behavioral therapy services were written for 233 children. Far fewer adults received prescriptions for 15 minutes of behavioral therapy services than children, with 320 prescriptions written for 33 adults in FY 2021-22.
However, data show the number of children and adults receiving treatment has increased in recent years. For instance, in FY 2017-18, 1,024 prescriptions for 15 minutes of behavioral therapy services were written for 143 children. Thirty-three adults received 320 prescriptions for the therapy services in the same year.
The data also show the number of children and adults receiving prescriptions for estrogen and testosterone increased in FY 2021-22 from previous years. In 2021, 391 prescriptions for estrogen were written for 151 children compared to 185 prescriptions for 72 children in FY 2017-18.
In FY 2021-22, 233 adults received 688 estrogen prescriptions. By contrast, 148 adults received 392 estrogen prescriptions in FY 2017-18.
More adults received written estrogen prescriptions than children, a data review shows. But the same is not valid for testosterone.
In FY 2021-22, 346 children were given 925 prescriptions for testosterone. By contrast, 143 adults were written 373 prescriptions during the same period. Again, it’s an increase from FY 2017-18 when 130 children were written 330 prescriptions for testosterone and 63 adults were written 174 prescriptions for testosterone.
Puberty blockers are only given to children. AHCA data show 180 prescriptions for puberty blockers were written for 55 children in FY 2021-22. That’s an increase from FY 2017-18 when 15 beneficiaries had 55 prescriptions written.
Florida’s medical boards are considering developing state-specific standards for treating gender dysphoria at the behest of state Surgeon General Joseph Ladapo. The Gov. Ron DeSantis administration has already amended state Medicaid regulations to ban providers from reimbursing for treating gender dysphoria, regardless of the patient’s age.
The administration wants the medical boards to adopt state-specific regulations to make it a practice violation for doctors to treat gender dysphoria in people under 18.
The Florida Boards of Medicine and Osteopathic Medicine have scheduled a joint rules committee meeting Oct. 6 in Tampa. That’s one day before the entire Board of Medicine meeting and less than a week after a Sept. 30 meeting of the joint rules committee in Tallahassee.
The four-hour Tallahassee public meeting will include a combination of public testimony and “presentations from subject matter experts,” according to the public notice. It’s unclear what experts the medical boards will hear from because the state hasn’t published details.
An agenda for the Oct. 6 joint rules committee meeting in Tampa also had not been posted at press time. According to the notice, the meeting will start around 4 p.m. The notice does, however, caution the meeting can be canceled before Oct. 6.