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Fights Over Transgender Coverage Could Delay CHIP Reauthorization

Eric Risberg
Pediatrician Nelson Branco examines 6-year-old Julien Voy during a medical checkup at the Tamalpais Pediatrics clinic Friday, Feb. 6, 2015, in Calif.

A Senate committee has moved a bill to reauthorize Pennsylvania’s Children’s Health Insurance Program—or CHIP.

CHIP has existed for decades in Pennsylvania. But this time, the bill is controversial. It includes a component that would prohibit the state from insuring transgender kids’ transition surgeries and related needs, like counseling.

In August 2016, the commonwealth’s longstanding policy to not cover reassignment surgeries and associated services changed, when the Obama administration issued a rule saying Medicaid and CHIP couldn’t exclude or limit coverage for gender confirmation-related services.

But the Trump administration stopped enforcing that rule. And now state lawmakers have to decide whether coverage should continue.

Senate Democratic Appropriations Chair Vince Hughes said right now, he’s focused on making sure CHIP reauthorization isn’t affected.

“Potentially we could be disrupted by something I think is completely unnecessary and clearly, clearly, has discriminatory aspects to it,” he said.

The component of the bill being debated is an amendment introduced by Armstrong County Republican Donald White, who said in a statement that it’s “inappropriate” for the CHIP program’s “limited resources to be used for sex change procedures.”

Casey Long, legislative director for Senate President Pro Tempore Joe Scarnati, who supports the amendment, estimated that services for transgender minors cost about $200,000 annually.

“We do not believe that the administration has the authority to require that coverage, when we currently have state regulations in place that prohibit that sort of coverage,” he said.

Pennsylvania spent over $56 million state dollars on CHIP last year, and over $535 million total.

CHIP Reauthorization has to happen by the end of the year, or the program will expire.

A spokesman for Governor Tom Wolf said he strongly opposes White’s amendment, and added that “Republicans in Washington and Harrisburg should stop playing politics with children and their families and the general assembly should send the Governor a clean CHIP re-authorization.”