UPDATED–The New Hampshire Department of Health and Human Services has proposed to eliminate the Medicaid rule that prohibits the program from funding sex reassignment surgeries.  Disturbingly, while the proposed rule change hasn’t even been heard yet, Girard at Large has obtained a letter sent by the department directly to a minor child enrolled in the NH Healthy Families program.  The child to whom this letter was addressed is 11 years old.

According to information contained on the department’s Rulemaking Notice Form:

This proposal amends the rule, by deleting paragraph (g), to remove the categorical prohibition of coverage of gender reassignment surgery.

The form includes information indicating the proposal is being made to bring the state into compliance with an administrative ruling from the federal Department of Health and Human Services’ Office of Civil Rights.  While the document asserts that the cost of the rule change cannot be known, it notes that any payments for said surgery would come from the state’s general fund and federal Medicaid funds.  In other words, both state and federal taxpayers would be on the hook for the sex change surgery.

A public hearing on the matter is scheduled for August 24th.  Exact details are contained within the Rulemaking Notice Form.

While many will find this proposal troubling, it appears as if the state isn’t waiting for the rule change to wind its way through the normal process.  As mentioned above, an 11 year old child in the NH Healthy Families program, which is part of the state’s Medicaid program, received a notice of coverage change stating that, effective July 1, 2017, the policy now covered sex change surgery.  (See page 3.)

The letter to a child begs several questions.  Among them are critical questions that have been raised:

  • Does the state actually intend to allow and pay for sex change surgeries on pre-pubescent children?
  • Will the state allow and pay for sex change surgeries on adolescent children who have not reached the age of majority?  (Age of majority is when an individual can legally “sign for themselves” or is no longer legally subject to parental authority.)
  • If so, will they do it with or without parental consent?
  • Will parents be prevented from knowing their children are considering sex change surgeries, or from having the surgery until after the fact because of the state’s desire to “protect” a child’s “privacy rights?” 

This story is still developing and our sources are diligently working to develop additional information.  We expect to have much more on this topic before the public hearing and encourage members of our Large and Loyal Listening Audience to keep tuned into the show’s daily guest calendar as we expect there will be guest hosts that will address this and related topics between now and the public hearing on the proposed rule change on August 24th.

Once again, we thank the members of our Large and Loyal Listening Audience for bring this rather quietly introduced rule change that appears to have already been changed outside of the statutorily defined process to our attention.

UPDATE:  Since posting this article, we have received word from several whose children are insured through Medicaid’s NH Healthy Families program.  All of their children, no matter how old (the youngest we’ve heard of is 5, the oldest is 17) have received the same letter we’ve published here.  So, it would seem the DHHS is intent on providing something that has yet to be approved through the rule-making process.