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“GOVERNORS HAVE A LOT OF FLEXIBILITY OVER THE MEDICAID PROGRAM AND THE BENEFITS THAT ARE INCLUDED.”
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Lady Beast’s frontwoman Deborah Levine on her music and life philosophy. A feature on the band’s record-release show appears on page 16.
Aspie Seeks Love documentary subject David Matthews discusses dating on camera in a CP Q&A. A feature on the film is on page 25. www.pghcitypaper.com
Listings editor Celine Roberts takes over the reins of the #CPWeekend podcast, which goes live every Thursday at www.pghcitypaper.com.
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Health-care advocates say Gov. Tom Wolf has the authority to cover transgender health care without legislative approval {BY ALEX ZIMMERMAN}
M
ARTY SELTMAN is used to con-
veying uncertainty to his transgender patients. Lately, it’s not a concern over which hormones to prescribe, or in what doses, or their effectiveness. It’s whether prescriptions for his trans patients, many of whom are on Medicaid, will go through at all. “There’s no certainty about what’s covered and not covered,” says Seltman, medical director at Metro Community Health Center in Swissvale. “I tell [trans patients] that we’ll put it through and see what happens.” That uncertainty comes in part because Medicaid coverage of transitionrelated care isn’t consistent. State Medicaid regulations prohibit treatment including hormones and surgery for
PITTSBURGH CITY PAPER 03.25/04.01.2015
trans patients, but sometimes, hormones are reimbursed. “If their insurance says that they’re a man, but they’re a trans woman and they get a prescription for estrogen, chances are they won’t be covered because it’s a male getting estrogen,” Seltman says. “But if they’re officially female, it’s much more likely they’ll get covered.” As for surgery — often a crucial part of the transition process — forget it. LGBT health-care advocates across the state are hoping to make what are increasingly seen as medically necessary interventions consistently available for transgender people who receive Medicaid. Earlier this year, a bill (HB 304) was introduced to the state legislature that would require all plans to
cover transition-related care. But even that bill’s sponsors acknowledge it could take a generation to shepherd it through the legislature. That’s partly why some advocates are quietly pursuing a different strategy, one that would need support from Democratic Gov. Tom Wolf, but not the Republican-controlled General Assembly. Their approach would take advantage of the governor’s authority to shape the state’s Medicaid benefits package, something he’s doing anyway as part of his promise to expand Medicaid under the Affordable Care Act. And it would also tap into his power to initiate a process that can undo the Department of Human Services regulations that currently exclude trans-related health