Illinois Governor Announces Medicaid to Pay for Gender-Affirming Surgeries

Illinois Gov. J.B. Pritzker announced, on Friday, that the state's Medicaid program would start covering gender-affirming healthcare.

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

“Healthcare is a right, not a privilege, and I’m committed to ensuring our LGBTQ community and all Illinoisans have access to that right,” said Pritzker. “Expanding Medicaid to cover gender affirming surgeries is cost effective, helps avoid long term health consequences, and most importantly is the right thing to do. With continued attacks coming from Washington, this administration will always stand with our transgender community and their right to lead safe and healthy lives.”

According to the administration, the proposed rule 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, said the governor's office. Last year, about 2,500 prescriptions for hormone therapy were covered.

Coverage for eligible trans and gender-nonconforming Illinoisans could be available as soon as this summer following a public comment period.

“For those facing gender dysphoria, every day can be a painful challenge,” said Theresa Eagleson, director of Illinois Department of Healthcare and Family Services. “Helping these individuals overcome their struggles through compassionate and comprehensive treatment is the right approach for them and for Illinois. They may not be a major portion of our total Medicaid membership, but the coverage can be so vital for everyone confronting this.”