Working with Lambda Legal, an LGBTQ+ advocacy organization, Swan Being, a transgender woman in her 70s, sued Alaska over its exclusionary policy in March 2019. Robin Black and Austin Reed later joined her suit as two additional plaintiffs, reporting they received a lack of coverage for hormonal treatments and surgery.
Being sued after learning that her travel expenses related to seeking health care were not covered, even though, as a rule of thumb, travel expenses are covered under Alaska Medicaid. Being had to travel from her home in Homer to Anchorage for treatment, and even though her doctor thought the travel expense would be covered, it wasn’t. Why was that? She was told “hormonal injections and lab work” for gender affirmation were not covered. Thus, neither was even the associated travel. Even though her doctor believed it medically necessary, even though she had health insurance.
Depending on your own circumstances, travel costs might not be a big deal. But remember that low-income folks deserve accessible, affordable health care, too. And as Northern Justice Project attorney Goriune Dudukgian pointed out, as reported by Alaska Public Radio, not everyone lives in an area with close options.
“For folks who are living in the off-the-road-system communities, or where they can’t get care within their own communities, the travel component is a really big deal,” Dudukgian stated.
In the end, the case, Being et al. v. Crum et al, was settled out of court, and the three plaintiffs will receive $60,000 each in damages. The Medicaid policy to categorically exclude “treatment, therapy, surgery, or other procedures related to gender reassignment” is struck as part of the agreement.
If you’re curious about how much this change in policy is likely to cost the state, it’s estimated that it’ll be about $28,000 per year, according to Lambda Legal attorney Carl Charles. Charles described the change as “lifesaving,” adding that in the big picture, “It will cost the state very little to make these people’s lives really measurably improved.” Charles noted the relatively low cost to the state is partially due to how few openly trans people live in Alaska, and beyond that, how few openly trans folks live in Alaska and receive Medicaid.