• Non-Binary Americans Can’t Get Health Insurance

    Did you know that there are no health insurance options for non-binary people in the U.S.? Whenever you apply for health insurance, the application asks for your gender/sex, and every application only has male/female options.

    When I corrected my birth certificate to state that I’m “non-binary,” I called my health insurance provider to update my account. They said they could not do the update because their insurance plans are specifically and only for males and females.

    Photo by Ivan Radic (Creative Commons)

    Health Insurance Broker Claims They Could Help

    In the summer of 2022, I received an email from the State Bar of Arizona with information about its health insurance exchange. I snarkily responded that I cannot get health insurance because I’m non-binary. The rep for the program sent me a response that said they were “confident” that they could find me a health insurance plan because federal law prohibits discrimination based on gender.

    My thoughts were dripping with sarcasm. I thought they were coming from a good place, but I didn’t think they knew what they were talking about.

    Wait – The Rep Found Me Non-binary Health Insurance?

    A few months later, when open enrollment started, the rep from the health insurance exchange sent me an email saying they’d found me some options for health insurance.

    Really?! I figured, if they even bothered writing me back, that they would saying they couldn’t find any options for non-binary people.

    Intrigued, I clicked on the link to the options they found. My curiosity quickly shifted to anger when I saw that the rep classified me as “female.”

    What the fuck, dude! (I thought it. I didn’t say it.)

    I sent them an annoyed, but respectful, response that I explicitly told them months ago that I’m non-binary, not female. (This is the issue I’ve been dealing with for years.)

    The rep responded that every health insurance option requires the applicant to declare themselves as “male” or “female.” I messaged them back with something like, “Welcome to my non-binary life.” I refuse to declare a gender that’s a lie.

    Photo by Thomas Backa (Creative Commons)

    Obnoxious Emails from HealthCare.gov

    Open enrollment also meant the beginning of a slew of emails from HealthCare.gov about researching and applying for health insurance under the Affordable Care Act. Every time one of these messages arrived, I became more and more prickly.

    I finally replied to one of these emails with “I can’t get health insurance because I’m non-binary.” Less than a minute later, a response arrived:

    “The email is not monitored.”

    Damn it!  

    Photo by Timo Kohlenberg (Creative Commons)

    I Called the Government

    When HealthCare.gov did not provide an option to email the government for help, I picked up the phone and called them. I clicked through their menu of options to get to a human, a polite man with a southern accent.

    I explained to him that I’m non-binary and there are no health insurance options for people like me on their site. His response: “Let me put you on hold and ask my manager.”

    When he came back on the line, the rep said a trans person can claim their new gender, male or female, when applying for health insurance. I told him again that I’m non-binary, not male or female, and that’s what’s on my birth certificate, driver’s license, and passport.

    “Birth certificate?”


    “Let me put you on hold and ask my manager again.”

    When he got back on the line, he was apologetic, but said that every health insurance plan requires you to state that you’re male or female.

    I knew this would be the answer. The point of making the call was to spread awareness about this issue, and I was curious to see how long it would take them to realize that non-binary people can’t get health insurance without lying about who they are. Before hanging up, I asked the rep to please let his manager know that this is a problem impacting all non-binary Americans.

    I also set my email up to automatically send all future emails from HealthCare.gov to spam.

    Why I Keep My Current Health Insurance

    I need health insurance to cover my medications and to be there if something catastrophic happens. If I didn’t, I’d approach an organization like Lambda Legal or the ACLU about teaming up, giving up my incorrect health insurance plan, paying the penalty on my federal taxes, and suing the government and/or health insurance providers for gender discrimination for not providing a health insurance option for non-binary people.

    Photo by Joe Abbruscato

    Hope on the Horizon

    The Social Security Administration is expected to add the X gender option sometime in 2023. Hopefully, this is the last year we have to identify as something we’re not in order to get health insurance. (Trans men and women were recently given the ability to update their social security records without needing a doctor’s letter.)

    I think social security is the last piece of the puzzle. Once someone has “non-binary” on every document across the board, I don’t think health insurance providers can get away with not having non-binary health insurance options or an option that doesn’t require the applicant to disclose their gender.

    Perhaps a non-gendered option will have a questionnaire that will ask about what body parts we have as well as what types of medical treatment or procedures we’ve had to date.  That seems fair and reasonable to design coverage based on your current health care needs. If you don’t have a prostate, you don’t need coverage that includes prostate cancer. Likewise, if you can’t get pregnant, you don’t need coverage for prenatal care or delivery.

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  • My Thoughts on the American Health Care Problem

    I have pretty strong beliefs about personal responsibility when it comes to health. As written, I don’t support Obamacare. It is program designed to make us more dependent on the government. When it comes to politics, I believe in less government, more personal freedom and responsibility, and that my money should be my money. I think most government and employer-provided health insurance should be eliminated and individuals should buy their own health insurance if they want it.

    Stethoscope and piggy Bank by 401(K) 2013 from Flickr
    Stethoscope and piggy Bank by 401(K) 2013 from Flickr

    Here’s how health insurance works – when you buy an individual plan, the insurance company hopes that the amount they spend on your medical care will be less than what you pay into the plan. When you’re in a group plan (like through your employer) they hope the amount they spend on the group will be less than what the employers and employees pay into the plan. If you connect the dots, you’ll see that a group plan favors the sick and irresponsible because they pay less than what they’d pay for an individual plan and the insurance company can use the funds from the healthy people who don’t need much health care to offset the cost of paying for them.

    I’m an entrepreneur. I pay for my own health insurance. I don’t want to pay for yours. Unfortunately, thanks to Obamacare, that’s exactly what I’ll be doing.

    I’m a huge proponent of personal responsibility and taking responsibility for your actions. Since started to have employer and government-provided health insurance, I wonder if it’s led people to think that they can neglect their health because someone else will be picking up the tab. I wonder if people would change their habits if they had to directly endure the financial consequences for their bad health.

    I think health insurance should be more like car insurance. If you always have to pay for it, you’ll budget for it in the present and the future. If we each had our own health insurance plans, we wouldn’t worry as much about losing our coverage if we lose our jobs or retire. If people planned for their financial future, maybe we wouldn’t need Medicare anymore. Additionally, health insurance companies would have to compete more for your business and might offer lower priced plans.

    There is an argument that if everyone had to buy their own health insurance that the price would get so high that only a few could afford it. That could happen, but I suspect someone will find a way to offer a lower priced program and make more money by making less money per plan but selling more plans overall.

    If health insurance was more like car insurance, your rate would be based on your habits and past behavior. This would encourage more people to be responsible for their health. If you want your car insurance rate to go down, you have to be a better driver. Likewise, if you want your health insurance rate to go down, you need to take better care of yourself.

    I wonder if this country would have fewer health problems if we never had employer or government provided health insurance. The responsibility for one’s health would be on the person. If they wanted to be unhealthy – that’s their choice, but they’d also be responsible for the physical and financial consequences. And if a person chose not to get health insurance, that’s their prerogative. They can pay cash.

    My idea comes with one exception: health benefits for the military. Our servicemen and women served our country and got many of their health problems from their service. We have an obligation to take care of them.

    I know my idea has flaws. If we implemented my idea now there would be a significant portion of the population that couldn’t or wouldn’t get their own insurance and will use ERs for medical care. My plan also requires providing more education about maintaining your health – but if someone chooses not to apply the lessons to their life, that’s their problem.  The most we could hope for is some people will see people not make changes and make the personal choice to not repeat their mistakes.

    I know I’m in the minority on this issue and it’s ok if you disagree with me. Feel free to share your views as a comment.

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