Kaiser Foundation Health Plans of Washington announced they now cover medical procedures requested by transgender women, like breast augmentation and chest reconstruction surgeries. Covering those procedures is fine — Kaiser is a private company and should be free to do what it wants — but the company is doing so because the state’s insurance commissioner, Mike Kreidler, an elected Democrat, pounced on the company for allegedly denying three people services.

This is absurd and not only an abuse of Kreidler's position, but it's also a hit against Kaiser and any future insurance companies who may likely feel pressure to change their policies due to backlash. Kaiser recently expanded coverage to the state of Washington and the company does cover transgender medical surgeries in other states.

According to complaints, “The two companies [Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc.] were specifically excluding breast augmentation to transgender women, yet they were paying for chest reconstruction for transgender men and for cisgender women who have had a mastectomy.” If this is true, it is a violation of Obamacare, since insurers must cover services for transgender individuals the same as they do for cisgender people. The Department of Health and Human Services said last year they would roll back some of these policies, but it has yet to be solidified.

It’s easy to see why companies like Kaiser hesitated on the medical front. Dr. Walt Heyer, who had sex reassignment surgeries himself and has discussed this extensively, wrote that sex reassignment often isn’t a good idea.



In 1979, Dr. Ihlenfeld warned his colleagues about unsuccessful outcomes . Based on six years of experience treating over 500 people with cross-gender hormones, Dr. Ihlenfeld sounded a warning on gender transition. He found that there was simply too much unhappiness among patients after changing genders, and that too many people who had sex change surgery later took their own lives. In his medical opinion, 80 percent of those who want a sex change should not do it. And for the remaining 20 percent, he found that that the sex change would only provide a temporary reprieve, not a lifelong solution.



From a free market perspective, forcing an insurance company to cover transgender surgeries for what likely amounts to less than 1 percent of their insured patients might ultimately do more harm than good in terms of pure economics. If companies want to offer this, let them do so, and let patients who desire these procedures to pay for coverage from them. Insurance, like other commodities, is not in the market of following the latest in physiological trends, but in the business of providing insurance.

The real issue here is that the policy was implemented via Obamacare in the first place. The Trump administration, if it cares at all about the rights of private companies (particularly private, religious companies, who do not want to offer these medical procedures as a matter of conscience), needs to mitigate the effects of this provision (Section 1557) as soon as possible. It’s a matter of medical, political, and economic importance.

Nicole Russell (@russell_nm) is a contributor to the Washington Examiner's Beltway Confidential blog. She is a journalist who previously worked in Republican politics in Minnesota.