Erin Reed at Erin In The Morning Substack:
Florida has become well-known as one of the worst states for anti-trans policies in recent years. After failing to pass a ban on gender affirming care for transgender youth, Governor Ron DeSantis used a handpicked Board of Medicine to enforce the same ban. Additionally, the state has cut Medicaid coverage for gender affirming care for transgender adults, and the 11th Circuit Court of Appeals recently ruled that schools can discriminate against transgender students regarding bathroom access. While the number of anti-LGBTQ+ bills proposed in Florida this year has been lower than expected during the start of this year, activists have been anticipating an increase. Now, the “Reverse Woke Act” has emerged as one of the first anti-trans bills in Florida of the 2023 legislative cycle. This bill would hold employers accountable for the detransition of any person who receives gender affirming care coverage for the rest of their life, potentially deterring coverage for many transgender adults in Florida.
The bill creates an impossible requirement for companies: if they provide health insurance coverage for gender affirming care, they are responsible for any procedures to reverse that care for the entirety of the individual’s life. As there is no set time limit for this liability and the mandate extends to “any benefits” that cover gender affirming care, companies may conclude that the risk of offering such coverage is unacceptably high.
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The provisions are ridiculously broad and lack precedent in law. If an individual undergoes a surgical procedure, such as a knee operation, and later regrets it or desires to modify it, no employer is liable for it a decade later simply because the company’s health insurance covered the surgery. That liability is between the patient and the doctor, and often would carry some form of statute of limitations. This not only extends the statute of limitations to perpetuity, it targets the employers just for having health insurance that covers gender affirming care. This targeting of the company itself for the procedures covered under its health insurance is designed to get companies to drop that care.
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Florida is not the only state that has targeted adult health insurance in recent months. We have seen somewhat similar bills pop up in Tennessee and Texas. Texas SB1029, introduced on February 17th, seeks to make health insurance plans strictly liable for all claimed “gender affirming care damages” for life if they offer that care without limitations. It also targets doctors offering that care by making them liable for malpractice. Taken together, they are designed to deter the provision of gender affirming care by both health insurers and doctors past the point of feasibility. Tennessee’s HB1215 would make any health insurance company that contracts with TennCare not offer coverage for gender affirming care. Both of these bills target transgender adults, not just trans youth.
Florida’s “Reverse Woke” bill SB952 is just another sneak attack on gender-affirming care that could force health insurance providers to drop gender-affirming care services on the basis of being “risky.”