House holds its position on more stringent gender-affirming care ban

As Florida Republicans call for a new law designed to ban gender-affirming health care, GOP legislators in the House and Senate now disagree on how far they should go.

With the clock beginning to wind down on the 2023 Session, House Republicans led by Rep. Randy Fine rewrote the Senate bill (SB 254) to include a provision that would not only ban the procedure for minors, but also would block commercial insurers from reimbursing gender-affirming care procedures.

The insurance ban is unusual since Florida legislators have usually mandated that insurers offer coverage, as opposed to telling an insurer it could not provide a certain type of coverage.

The House also wants children currently being treated to no longer have access to treatment or hormones effective Dec. 31, 2023. The Senate bill, which cleared that chamber last month, allows the Florida Board of Medicine and the Board of Osteopathic Medicine to determine the fate of the minors already in treatment.

The House is poised to approve this revamped bill as soon as Wednesday.

Ahead of that vote, House Democrats filed 26 amendments that were shot down on voice votes.

As has been par for the course this Session, debate on the bill was marked by accusations of child abuse, mental illness and unfounded science. Several people who opposed the legislation threw underwear and shirts into the House chamber. One of the pieces of underwear displayed a message saying “fascism has no place in Florida. Stop trans genocide.”

Rep. Robin Bartleman tried unsuccessfully to strip the provision that required minors currently in treatment to stop taking puberty blockers by the end of the year and to instead defer to the Senate position. Bartleman, who has said she has a friend who allowed her child to transition, noted that “all the Republicans in the Senate approved it.”

But Fine asked House members to shoot it down.

“Our bill says if you are a child on these you can continue until the end of the year if you started before January 1,” Fine said, saying that the goal is for the minors to stop taking the drugs by the end of the year.

Rep. Ralph Massullo, who co-sponsored the House ban on gender affirming care along with Fine, also spoke against the amendment, noting that the goal is to “prevent child abuse which we would all agree is illegal in this state,” Massullo said.

Bartleman chastised Massullo for the remark.

“To tell my friend she is abusing her children is not kind,” Bartleman said.

Rep. Anna Eskamani offered several amendments to Fine’s proposal, including one that would have created a civil cause of action for people who were denied access to care.

She said she was “concerned when we deny access to care for people or take away that care for them, there could be some very serious mental harm,” she said. “I want to make sure there is a path of responsibility for people to seek justice if that situation does occur.”

Fine pressed Eskamani on whether the prohibition of state funds could trigger a cause of action, asking if the only way to avoid litigation was to pay for the care. And Massullo pressed Eskamani on the types of service denials that could trigger a lawsuit.

Banning transgender health care to minors and limiting it for adults is one of the priorities of the Gov. Ron DeSantis administration and state Surgeon General Joseph Ladapo.

The DeSantis administration passed a rule banning Medicaid from reimbursing for gender-affirming or gender-confirming health care for all residents. That rule is being challenged in federal court.

The Governor also pressed the Board of Medicine and the Board of Osteopathic Medicine to alter their standard of care rules to ban the provision of gender-affirming care to minors.