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Medicaid Expansion & Trans Health: “Not Going To Break The Bank To Provide A Better Life For All'

Jordan Richards and Tracy Davis both work at The Center Project, an LGBTQ+ resource and community center for Mid-Missouri. They spoke about what Medicaid expansion – or a lack thereof – could mean for transgender Missourians.

Recently, Missouri legislators have stood in the way of funding Medicaid expansion in the state – defying a constitutional amendment that was passed last year by voters – and neighboring states, like Arkansas, are passing legislation which would make providing gender affirming medical treatment to minors illegal.

Meaning it may soon be even more difficult for trans people to access healthcare – gender affirming or otherwise.

Missouri Health Talks gathers Missourians’ stories of access to healthcare in their own words.

Jordan Richards: I really think we need to look at places like Oregon, California, New York – all these places that have Medicaid coverage for trans individuals for transitional care, and the coverage is not breaking the bank on the states. It's not costing them millions and millions and millions of dollars.

You often hear that rhetoric a lot about how much it's going to cost for these procedures that they don't consider “medically necessary” and all these things, but in reality, it's not costing them that much.

But when you have a trans person that cannot transition, you know, medically, that causes higher rates of depression, higher rates of suicidality.

Then the state is therefore paying for these secondary health concerns, which is directly related to not letting trans people transition.

Tracy Davis: Medicaid is a vital program for health coverage for millions of people with low incomes, including LGBTQ individuals, and according to a transgender discrimination survey, transgender, non-binary and gender non-conforming people are three times as likely to have a household income under $10,000 and three times as likely to be unemployed as a typical person in the United States.

Now, compounding that fact is that Missouri is one of nine states that does not follow federal law, and does not provide the full range of gender affirming care in their Medicaid programs.

So, it can be very difficult even to access gender affirming health care. It can be more difficult to have it paid for. It's prohibitive – the cost can be quite prohibitive, honestly, and shifting the financial burden of medically necessary gender affirming health care on to transgender Missourians, means we have less capital to spend in the struggle for equality.

So, it's a method of maintaining power relations and societal hierarchies.

Jordan: I think like Tracy said, the idea behind making it so hard to transition and making it so costly is being trans is like, to most – to a lot of people, I don't know if I would say most people - but a lot of people in government, being trans is like, the thing they're trying to avoid.

Like, they want to make it so hard and so costly to transition, that people just won't be trans anymore, and that's not realistic. I mean, people are going to be trans and all they're doing by making it not accessible is they're causing more health problems.

Tracy: Jordan is right.

And as far as how much it costs, I mean, let's do some quick math in our head. If there's like 6.15 million people in Missouri and about 1 percent of people are trans – that's what? 61,500 people?

There's more people in St. Charles, darling.

I think that it's not going to break the bank to provide a better life for all Missouri residents.

Hannah France is a convergence radio student at the University of Missouri’s School of Journalism – set to graduate with her Bachelor of Journalism in May 2021.