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LGBTQ+ fights for equal healthcare

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The rainbow flag, a symbol of gay pride and equality. Photo by Michael Costa

Organizations in the LGBTQ+ community are joining forces with transgender educators to bring awareness to an exclusion of gender-affirming care by the current health care insurance provided by Cuesta College, San Luis Obispo County, and over 40 districts throughout California.

Recently, leaders of the Central Coast LGBTQ+ community were informed that employees of Cuesta College are being subject to an exclusion clause in their employee health care plans. The exclusion from the health plan is in regards to gender-affirming care, which is impacting various employees at Cuesta College and throughout the county.  

Currently, over 40 school districts are using the Municipalities, Colleges, Schools Insurance Group (MCSIG), which is a Joint Powers Authority (JPA) created and operating under the Government Code and the Education Code of the state of California. According to their mission statement, the insurance group is committed to establish, operate, and maintain a health benefits program for the mutual benefit of the parties utilizing the principles of collectively pooled underwriting, risk sharing, shared expenses, health management, and cost-containment services.

On Jan. 20, LGBTQ+ organizations, including Tranz Central Coast (TCC), The Gala Pride and Diversity Center, and the Central Coast Coalition for Inclusive Schools began correspondence with both Cuesta College Administration and Human Resources, as well as MCSIG. The letter brought attention to three major areas of concern: the exclusion of gender-affirming health care, the discouragement of both transgender and gender diverse employment at Cuesta College, and the conflict with current policies of the San Luis Obispo County Community College District. 

These concerns were well received and acknowledged by Vice President of Human Resources and Labor Relations, Melissa Richerson, who in return responded encouragingly on Jan. 21. Along with the support of Cuesta College President Jill Stearns, the letter recognized and appreciated the advocacy of the LGBTQ+ community. They also expressed their continued dedication to work with MCSIG and to encourage the inclusion of gender-affirming medical coverage, as well as other currently excluded treatments. 

“The SLO District will continue to work with MCSIG to encourage the inclusion of Gender Affirming medical coverage, as well as other currently excluded treatments,” Richerson said. “Your advocacy is recognized and appreciated. The district will continue to express support for inclusiveness for all in our medical plans.”

Over the months, LGBTQ+ supporters have developed an on-going and productive dialogue with Cuesta College Vice President of Human Resources & Labor Relations Melissa Richerson and Human Resources Specialist Monica Blandford. Richerson continues to be receptive to all emails and calls. The LGBTQ+ team replied to Cuesta College in a letter dated Jan. 27. 

“As we stated in our January 20, 2020 letter, the exclusion of gender-affirming care from MCSIG plan is illegal under the California law and inconsistent with the non-discrimantion policy of the San Luis Obispo Community District,” said Jamie Woolf, Chair of Tranz Central Coast. “Because removal of this exclusion is a priority for our organizations and the persons for whom we advocate, we urge you to continue applying pressure to MCSIG.” 

When it comes to advocacy and putting on pressure, TCC, GALA, and the Central Coast Coalition for Inclusive Schools don’t plan on stopping until they reach their goal. That means going as far as taking their concerns to the San Luis Obispo County Community College District Board.  For the groups fighting for equal rights, they are distressed to see that in the year 2020, a public college in California would engage in this type of explicit discrimination against transgender people. 

At a recent board meeting in March, the three organizations testified to the Board of Directors the importance of complying by statute that governmental entities such as MCSIG are subject to both federal and state law.

“In addition to state law, courts across the country have held that transgender exclusionary policies in self-funded plans like MCSIG’s are illegal under the Equal Protection Clause of the 14th Amendment and Title VII of the Civil Rights Act”, said Doug J. Heumann, GALA’s board of directors president. “Whether under state or federal law, these discriminatory policies are patently illegal.”

For those involved in the crusade for health care equality, the stories are all too similar. Both state and federal law explicitly prohibit unlawful discrimination based on gender identity, gender and gender expression. Kristen H. Kent, Chair of the Central Coast Coalition for Inclusive, shared her story of discrimination years ago with the Cuesta College Board of Directors on March 4, 2020.  

Kent recollected her first teaching job in 1992, and a conference she attended by a teacher who belonged to GLSEN (formerly the Gay, Lesbian and Straight Educators Network). She was empowered by the courage of the speaker, who told her story of a student who asked if she was a lesbian. She responded yes, because it wasn’t in her nature to lie or to hide herself.

“Later when one of my seventh grade students asked me if I am a lesbian, I took a breath and said, ‘Yes, Danica, I am,’” Kent said.  “A month later the principal of the local middle school told me he would not have a job for me for the next academic year.  I lost my job because of one aspect of who I am. 1992, it wasn’t that long ago, or was it?”

Another lawsuit that is pursuing a case of exclusion by MCSIG was submitted by Kiera Benidettino, an employee of the Salinas Unified High School District (SUHSD). According to legal papers submitted by California Rural Legal Assistance, Inc., to both MCSIG and SUHSD, Benidettino claims that her family has been subjected to an exclusion in her employer-provided plan regarding gender affirming care, causing her family to have to pay out of pocket for medically necessary care for their transgender child.

Situations like the above are just a couple of examples of why LGBTQ+ community leaders are coming together to ensure that the board from both Cuesta College and MCSIG have accurate information to base their decisions. Moving forward, their main goal is for all transgender/non-binary people in California to have access to the medically-necessary care they work for and deserve.  

“Cuesta has made requests for proposals from other insurance companies,” Woolf said. “This doesn’t mean Cuesta is leaving MCSIG, but it shows the college is considering its options in a very responsible manner.”

MCSIG argues that removing the discriminatory exclusion is costly and would constitute a rate increase ranging from 0.5%-3% just to provide gender affirming. A report by the California Department of Insurance Economic Impact Assessment concluded that even in a much larger population, according to The United States Court of Appeals for the Ninth Circuit, cost is not a justification for discrimination.

As with any LGBTQ+ issue, equality is the main goal. The leaders of the community understand that the board does not oversee the selection of health care plans, but feel strongly that it is their fiduciary duty to protect the entire staff that is hired to work in the district. 

“By statute, governmental entities, such as MCSIG are subject to both federal and state law,” Heumann said. “In addition to state law, courts across the country have held that transgender exclusionary policies in self-funded plans like MCSIG are illegal under the Equal Protection Clause of the 14th Amendment and Title VII of the Civil Rights Act. Whether under the state or federal law, these discriminatory policies are patently illegal.”

The LGBTQ+ officers are urging the immediate removal of any unlawful exclusions of medically necessary gender-affirming care from all health care plans offered by MCSIG for Cuesta College and all other entities covered by the health plan organization.

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