Georgia health plan would not cover gender-affirming care under bill that clears Senate

Georgia Republicans have spent several years limiting transgender rights. In 2023, the General Assembly passed a law that bans certain gender-affirming care for minors. The Legislature has never voted on curbing access to adults before.

Over the past decade, transgender people have successfully sued various state agencies — such as the departments of education and corrections — to receive different types of gender-affirming care that had been denied.

Policies at state agencies had blocked the State Health Benefit Plan from covering care such as hormone therapy or surgery. But, as part of settlement agreements between the transgender plaintiffs and the Attorney General Chris Carr’s office on behalf of the state, agencies agreed to cover gender-affirming care, as well as compensate the plaintiffs in those challenges.

“What this bill does is, in no uncertain terms, makes clear that you cannot use state taxpayer dollars in any form for transgender surgeries,” Tillery said. “That is the simplicity of it. That is the complexity of it. That is the entire bill.”

In addition to denying insurance coverage of surgeries on transgender patients the bill would also prohibit the state insurance plan from covering hormone therapy that is often prescribed to those diagnosed with gender dysphoria, the medical diagnosis given to most transgender people. Mental health counseling, often the first step taken by those experiencing gender dysphoria, would also likely not be covered.

Senate Democratic Whip Kim Jackson of Pine Lake unsuccessfully attempted to amend the bill to allow coverage of mental health treatments. Republicans voted against the effort.

The bill also does not include any exceptions for adults who, for example, might have been taking hormone therapy for more than 20 years, Jackson said.

Tillery stressed the bill would not ban those procedures, but it would mean that those on the State Health Benefit Plan — and those who receive Medicaid — would have to seek private health insurance coverage or pay out of pocket for treatment.

“Senate Bill 39 says we’re not going to use state taxpayer dollars to pay for transgender surgeries,” he said. “If you think we should, then vote (no)? If you think we shouldn’t, then vote (yes)? But I don’t think this bill says anything more than that.”

State Sen. Rashaun Kemp, a Democrat from South Fulton, called the series of bills being pushed by Republicans “mean spirited.”

“Here we are once again going after a vulnerable population,” Kemp said. “I want to give some breaking news: all of these efforts are not going to erase transgender men, transgender women, from our society. And that seems like what this body is trying to do.”

The legislation calls out Carr’s office for its role in the litigation, saying deals were reached with his “guidance.”

Tillery introduced SB 39 with the backing of Lt. Gov. Burt Jones, who has also pushed other legislation aimed at regulating transgender people. Jones is expected to face Carr in a Republican primary for governor next year. Carr announced his plans to run last year and Jones is expected to announce his campaign in the coming months.

SB 39 is the latest in a list of Republican-backed legislation that aims to regulate transgender people.

In 2023, the Georgia General Assembly passed a law banning doctors from prescribing hormone therapy or performing surgery on transgender minors. The law does, however, allow minors to receive puberty blocking medication. The law also allowed minors who already were receiving hormone therapy before the law took effect in July 2023 to continue treatment. A bill that would remove those exceptions is expected to be heard in a Senate committee this week.

Last week, the Senate also approved Senate Bill 1, which would ban transgender girls from competing on girls’ sports teams.