Iowa's House File 1049 bans Medicaid coverage for gender-affirming care for adults, a decision made without public comment by Gov. Kim Reynolds. Effective July 1, this law excludes hormone therapies and gender-affirming surgeries while allowing mental health services for gender dysphoria. Advocates claim the law is discriminatory, as similar treatments are available to non-transgender individuals. Iowa joins eleven states that restrict such care, despite significant endorsement for its medical necessity from numerous health organizations, highlighting the ongoing contentious debate on healthcare access for transgender individuals in the U.S.
"Yesterday the Governor signed into law an obviously discriminatory bill that limits healthcare simply because someone is transgender," Keenan Crow, Director of Policy and Advocacy at One Iowa, told The Advocate. "The bill provides these same medications and procedures for non-transgender Iowans without issue. It is unconscionable to restrict access to healthcare because of who someone is."
Iowa is now one of eleven states where Medicaid policy explicitly excludes transgender-related health care for all ages, according to the Movement Advancement Project.
The American Medical Association, the American Psychiatric Association, and other medical organizations agree that gender-affirming care is evidence-based and medically necessary not just for adults, but minors as well.
Iowa has previously attempted to prevent gender-affirming care from being covered under Medicaid. However, past attempts were struck down by courts citing unlawful discrimination.
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