Don’t require Medicaid or other health insurance plans to cover gender transition surgery.

The Iowa Legislature made the correct decision when they passed the bill that prohibited Medicaid from covering gender transition surgery.  One the one hand, it is morally correct and good public policy that our government not discriminate against a people based on their gender identity.  On the other hand, that does not mean Medicaid or any other insurance should be required by law to cover gender transition surgery.  Proponents of requiring such coverage say that it is medically necessary because of the mental distress that gender dysphoria may cause.  But, cosmetic surgery of any type has not been required to be covered just because a person feels bad about the way they look physically.
I’m sure some people feel great mental distress over their teeth being crooked, or their nose being too big, or many other aspects of their body, but that does not mean Medicaid (taxpayers) or other health insurance plans should be required to cover procedures to make people feel better about their appearance.  Requiring health insurance plans to cover almost everything makes the makes the cost unaffordable to almost everyone.  There is nothing inherently wrong with expecting people to pay their own way for cosmetic procedures.
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Gender reassignment surgery should not be required to be covered by health insurance.

As reported in the Des Moines Register, a jury recently found the State of Iowa guilty of illegal discrimination against a transgender man.  He had not been allowed to use the men’s bathroom or locker room, and he had been denied health insurance coverage for gender re-assignment surgery.  (See link below to Register article.)

It is morally correct and good public policy that our government not discriminate against a people based on their gender identity.  But refusal by government or private employers to cover gender reassignment surgery under their health insurance plans should not be considered wrongful discrimination, unless the plans cover other types of cosmetic procedures for people who feel similar dysphoria.  People may feel mental distress over their teeth being crooked, or their nose being too big, or many other aspects of their body, but that does not mean health insurance plans should be required to cover procedures to make people feel better about their appearance.  We have already seen that requiring health insurance plans to cover almost everything makes the premiums unaffordable for many people.  There is nothing inherently wrong with expecting people to pay their own way for cosmetic procedures.

Link to Register article: https://www.desmoinesregister.com/story/news/local/columnists/courtney-crowder/2019/02/13/transgender-prison-nurse-sues-iowa-alleged-discrimination-aclu-state-civil-rights-corrections/2863854002/