UI-Chicago insurance may cover gender reassignment
CHICAGO — The University of Illinois at Chicago is poised to join a growing number of colleges and universities that cover sex reassignment surgery as part of student health insurance plans.
At a meeting next week, the UI Board of Trustees will consider a recommendation to approve health insurance rates for UIC students. For the first time ever, the plan as proposed includes coverage of sex or gender reassignment surgery, the medical process by which transgender people change their physical, sexual characteristics to reflect their gender identity.
Ken Thomas, who recently graduated from UIC and has served as a student trustee for the Chicago campus, said students there proposed adding the benefit about two years ago as they learned of several other universities, such as Michigan and Northwestern, offering the coverage. A student fee advisory committee approved the additional coverage, and student leaders began working with campus administration to add the new benefit.
The proposal is in keeping with the campus's drive to be a welcoming place for all, Thomas said.
UIC recently was ranked 24th on Campus Pride's national index of LGBT-friendly campuses and scored high for its overall campus climate.
"It's important on the level of keeping that status, of treating LGBT students with the kind of respect they deserve," Thomas said.
Plus, "it doesn't break any budgets to add the benefit," he said.
Of the expected $60 per semester increase for student health coverage beginning this fall, about $4.50 is attributed to the gender reassignment surgery benefit.
At UIC, a campus that includes a hospital, medical college and clinics, students participate in a self-funded health benefit plan called CampusCare.
Students receive their medical care at UIC hospitals or approved regional facilities, and their emergency care is covered as an out-of-network benefit. The rates for 2013-2014 are proposed to be $461 per semester or $922 per year, up $60 a semester or $120 a year from 2012-2013.
Much of the increase comes from costs associated with changes added this school year, including the emergency care benefit and increases that occurred in the lifetime limit, according to Michael Ginsburg, associate vice chancellor for student affairs at UIC.
Increases are also attributed to the need for CampusCare to boost the amount it reimburses the UIC hospital.
The last time UIC students had a rate increase in the health insurance benefit was in 2008, according to Ginsburg.
Gender reassignment surgeries are not performed at UIC's hospital, so it will be an out-of-network benefit, according to Mike Jonen, associate vice president for enterprise strategy in the UI's Office for Vice President for Health Affairs. That means it will follow a 70-30 cost structure, with the student covering 30 percent of the costs. The lifetime limit on this benefit is $117,000, Jonen said.
Research has shown that few students use the benefit, by an average of less than one student per year, according to Ginsburg. And the process leading to any surgical procedures involves a lot of physical and psychological screenings and evaluations, Jonen added.
"We don't know within our student population how many students" would want the procedure. "This is private, confidential information between students and their physicians," Jonen said.
If a student has been moving toward the gender reassignment process, by taking hormones, for example, and is at the point where he or she is considering the surgery, "we'd help identify the out-of-network provider," Jonen said.
The proposal is pending approval from the UI board, which meets Wednesday in Chicago. Trustees regularly approve fees as part of their meetings.
"Given this is a controversial, emotionally charged issue, I could see how some taxpayers might object to some tax dollars going to this," said Dr. Tim Koritz, the UI trustee who chairs the board's health affairs committee. CampusCare is self-funded, but because some students receive financial assistance to attend UIC, with their tuition and fees covered, it's theoretically conceivable some tax dollars could go toward the benefit, he said.
CampusCare is funded 100 percent out of the student insurance fee, according to Jonen.
"That's a fee that has been vetted with the students and approved by the student fee advisory committee," he said.
Of UIC's 27,000 students, 11,000 are members of CampusCare. It is difficult to determine exactly how many of those are using state aid or university funds to cover the fee, Ginsburg said.
Participation in CampusCare is not mandatory. Students can choose not to participate in the program by providing documentation of other insurance coverage. And with the federal Affordable Care Act allowing students to be insured under their parents' plan until the age of 26, fewer students are on CampusCare, according to Ginsburg.
Koritz said he was looking forward to having a discussion with the full board about the program.
"The last thing I'd want to do is block the issue from going to the full board. The students have an interest in it, and (the board) should discuss it and make a decision," he said.
If approved, the UI will join 36 colleges and universities across the country which provide transition-related medical expenses, according to one national advocacy group.
The movement started around 2005, with early adopters being the University of California system and the University of Michigan, said Genny Beemyn, director of the University of Massachusetts Amherst's Stonewall Center. Beemyn compiled the Trans Policy Clearinghouse for Campus Pride, a national association that works with LGBT organizations on campuses.
Universities have followed the lead of private employers who started offering the benefit as part of their health insurance coverage in the late 1990s. Usually the push for coverage has come from either the students or LGBT campus centers, according to Beemyn.
"I think it's really critical because if we are saying that we're not going to discriminate against transgender students as part of the (college's) nondiscrimination statement, providing basic health care benefits is really part of nondiscrimination," Beemyn said.
"It's a big step" toward making a campus truly welcoming to transgender students, Beemyn said.
On the Urbana-Champaign campus, the student health plan does not cover gender reassignment surgery, nor will the plan that takes effect this fall, according to Ed Slazinik, the associate vice chancellor student affairs. Slazinik said he did not know if it has ever been proposed for that campus; it was not brought up earlier this year when the student fee advisory committee met to review student health benefit plans for the next school year.
Stephanie Seawell, a spokeswoman with the UIUC Graduate Employees' Organization, said some of their members have been following steps taken at UIC. The GEO has created a caucus focused on access and equality issues in health care and members are interested in transgender health and similar issues, she said.
As for university employees, whose health insurance is covered by the state because they are considered state employees, gender reassignment is not included in their coverage plans.