News

County opts out of Obamacare sex change mandate

By Bill Moss, Published: October 19, 2016

If a Henderson County employee wanted to go through a sex change operation, the employee won’t get coverage through the county’s health insurance plan.

The Board of Commissioners voted unanimously on Wednesday to opt out of gender reassignment coverage, which the Affordable Care Act requires many employers to offer starting on Jan. 1.
“If you did not act, a change is mandated Jan. 1,” County Manager Steve Wyatt told the board.
The ACA, or Obamacare, requires the coverage of sex change surgery and related drug therapy in many situations. However, the law allows self-insurers with more than 250 employees to opt out. Henderson County qualifies for the opt-out.
“Henderson County’s plan is self-funded,” Wyatt said. “We don’t buy traditional insurance off the market. If we did you would not have the option of opting out. Since we have our own plan we have the ability to design that plan. We have the ability to opt out under the law. My recommendation on this issue based on obvious factors of cost is that the board authorize the exception and opt out of the coverage.”
Responding to questions from Commissioner Bill Lapsley, Wyatt said he knew of no county employee who had requested coverage of gender reassignment surgery, nor did he know how much cost the county might be avoiding by opting out before the Jan. 1 mandate takes effect. The county insurance plan does not cover gender reassignment now.

The opt out requires the county to send a "letter of exception" to Blue Cross Blue Shield holding the insurer harmless for "any subsequent judgments and damages" resulting from the county's exception. The commissioners authorized the county attorney to draft the letter and send it to BCBS.