Iowa Senate File 538- gender transition procedures related to minors strips providers of Medicaid funding from Sept 18 forward and doesn't allow Medicaid to be used by clients for gender affirming treatment. If a counselor has a transgender client, and has used the gender dysphoria code and many others (7 pages of ICD codes) then they will be retroactively stripped of funding. I am so angry for clients and for providers. As a clinician, I feel so mad that states are telling transgender youth in lower SES that they can't be who they truly are, and now they can't even talk to a counselor. I just can't. @socialwork@Email2TootBot#SocialWork#psych#psychology#iowa#lgbtqia#transgender#transgenderrights#counseling#counselor#therapist#therapy
Christine -- This is horrible! What do you mean by retroactive? Does Iowa Senate File 538 claw back past payments? Cut providers off from Medicaid for past use of those billing codes? Does it totally drop those providers from the Medicaid program?
I'll go read this bill when I can -- clients in a moment to see.
Okay -- quick look -- seems already signed by the governor but not in force yet. Is this tied-up in court?
I am not sure how to copy the letter from Iowa HHS, but we were told that this is in effect retroactively from Sept 18. This is horrible, in so many ways.
And... apparently it is a professional code violation enforceable by any state officer or licensing board. So I would say that you are entirely forbidden from any gender affirming counseling of any type regardless of what insurance is in use.
Not a lawyer, but I'm unsure if liability insurance would cover you if you practice outside your license -- so potentially forget having any liability insurance when citizens sue you... Including the minor themselves up to 20 years after they reach the age of adulthood.
This kind of right-wing legislation is usually cookie-cutter, so we can reasonably expect this is being tried in about 1/3 of US states right now in some form.
When the right-wing seizes power in 2024/2025, expect this to go national at the Federal level.
This Desmoines Register article does mention other similar laws (like in Alabama and Arkansas) but again concentrates on puberty blockers and hormone therapy.
The Alabama law contains large sections that look duplicate -- I think we will find a think tank at work supplying this info.
Not sure if the following is the correct final text of the Alabama law. I don't see the billing prohibitions, licensing board issues, or citizen lawsuit provisions at fast glance. I do see a requirement for counselors and schools to inform families of gender disphoria related counseling.
The legislation is mainly about gender-affirming medical procedures, but would seem to rope in counselors also.
Gender-affirming treatment -- seemingly including mental health counseling that affirms "the minor’s perception of, the minor’s gender or sex, if that appearance or perception is inconsistent with the minor’s sex [at birth]"-- would seem to be a professional code violation enforceable by any state officer or licensing board if it leads to surgery or use of hormones.
[I'm unclear if there is a professional board violation if the counseling does not support or lead to further medical treatment. But Medicaid won't pay for it.]
So, what happens to an Iowa counselor who dares any gender dysphoria counseling if the client later gets hormone treatments or surgery out-of-state?
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