Effect of State-Level Policies That Ban Health Insurance Discrimination on the Basis of Gender Identity

• Activity Number: 428 - Contributed Poster Presentations: Health Policy Statistics Section
• Type: Contributed
• Date/Time: Tuesday, July 31, 2018 : 2:00 PM to 3:50 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Alex McDowell* and Adrianna McIntyre and Sherri Rose
• Companies: Harvard Medical School / Cambridge Health Alliance and Harvard University and Harvard Medical School

Abstract

Since 2012, 19 states have passed policies prohibiting insurer discrimination against gender minority beneficiaries. Such policies have important implications for access to care among gender minorities and use of gender minority diagnosis codes among providers who care for gender minority patients. We develop an algorithm to identify beneficiaries with gender minority diagnoses in a large commercial claims database in 2012-2015 and use a difference-in-differences design to compare changes in the percent of gender minority beneficiaries identified in states with and without non-discrimination policies. We find no evidence that the percent of beneficiaries identified as gender minority is higher in states that enacted policies compared to states that have not yet enacted policies. Additional research is warranted to better understand the effect of non-discrimination policies on health care access, service use, and outcomes among gender minorities. Future investigation in this area will benefit from use of nonparametric machine learning to develop synthetic controls.