Republicans in a Virginia House of Delegates subcommittee have dealt a blow to the commonwealth’s transgender community, defeating a bill that would prohibit discrimination in health insurance based on a person’s gender identity.

The bill, HB 1466, by Del. Debra Rodman (D-Henrico), sought to prevent health insurance companies from refusing to cover medically necessary procedures or treatments for transgender patients that would otherwise be covered for cisgender patients.

For example, if a cisgender female’s mastectomy would be covered by insurance, a transgender man should be able to have his mastectomy covered as well.

The bill would also have prevented insurers from attempting to charge transgender patients higher premiums to cover their transition-related expenses, and required insurers to assess what constitutes “medically necessary” care according to criteria that are consistent with medical standards.

The bill was defeated on a party-line vote, 5-3, with the subcommittee’s Republicans voting in favor of tabling the bill — effectively killing it — and the subcommittee’s Democrats voting against the motion to lay on the table.

LGBTQ activists were saddened over the bill’s defeat, as were women’s health and reproductive rights groups, which issued statements blasting Republicans on the subcommittee for their actions.

“No person should be denied health insurance coverage because of who they are. However, transgender patients often face barrier after barrier when seeking health care,” said Jennifer Allen, CEO of Planned Parenthood Advocates of Virginia. “We are disappointed that conservative delegates defeated HB 1466 that would have eliminated health insurance discrimination against transgender individuals.”

“The Conservatives still don’t get it. Gender, gender identity, [and] sexual orientation, like any other immutable characteristic, should not be used to deny people insurance coverage for necessary medical care. It is shocking that this is not the case in this, the 21st century,” Tarine Keene, the executive director of NARAL Pro-Choice Virginia said in a statement.

“We supported this bill because it would ensure that all Virginians are treated equally when it comes to obtaining health insurance and are able to receive the necessary medical care without facing unfair and archaic discrimination. It seems our Conservative legislators feel that discrimination is acceptable.”

In 2015, the National U.S. Transgender Survey found that nearly one in three transgender people who saw a health care provider faced mistreatment or discrimination in a health care setting, such as verbal harassment, refusal of treatment, or having to educate their provider about their own health options. One in four transgender people who did see a medical provider report that they were denied coverage for care related to their transition, even if the provider deemed it “medically necessary.”

That same survey found that 23% of respondents said they put off going to a doctor because of fears of a negative or discriminatory experience, and 33% said they delayed seeking medical care because of the costs that they would be forced to pay out of pocket. Additionally, while 78% of transgender people who sought out transition-related care were prescribed hormones, only 49% of them ever received it.

“Transgender people, like everyone, deserve to live their lives without healthcare providers denying or limiting coverage because of gender identity,” James Parrish, the executive director of Equality Virginia, said in a statement.

“We are disappointed that the Commerce and Labor subcommittee defeated Del. Rodman’s bill despite the recommendation of every major medical association who stand in agreement that transition-related care is medically necessary and should not be excluded from health insurance,” Parrish added. “Eighteen states plus D.C. have already adopted laws or regulations that protect transgender people from insurance discrimination, and we hope that soon Virginia will join them.”

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