Transgender beneficiaries of medicare and medicaid
This thesis explores the two largest public insurance plans in the U.S., Medicare and Medicaid, through a lens of equity and accessibility for transgender beneficiaries. This thesis centers the utilization of insurance systems through examining policy and literature, conducting a survey to transgender affirming healthcare providers, and analyzing a case-study interview with a transgender affirming insurance specialist in New Orleans, Louisiana. In sum, this thesis describes what is working well for transgender beneficiaries of Medicare and Medicaid and what needs to be reformed or expanded to improve healthcare access and equity. Chapter 1 is an introduction to the thesis and Chapter 2 is a literature review of the existing discussion of the demographics of transgender Americans, the histories of Medicare and Medicaid, and health concerns relevant for transgender individuals. Chapter 3 introduces my guiding research questions and Chapter 4 outlines the methodology I utilize to answer them. Chapter 5 examines my survey results and Chapter 6 examines my case-study interview results. Chapter 7 synthesizes my findings as answers to my research questions and Chapter 8 concludes the thesis, explaining the needs for Medicare and Medicaid to be reformed and expanded to improve health care implementation for transgender Americans. Most significantly, the administration of these public insurance plans is riddled with bureaucratic barriers that disproportionately hinder transgender patients. Reforming and expanding public insurance in the U.S. are essential to establish medical and social equality for transgender people.