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ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
VETOED
insurance; gender surgeries; documentation; reports
Purpose
Prohibits a health insurer that offers coverage for gender transition services from denying coverage for gender detransition services and requires outlined health care providers that perform gender transition services to provide gender detransition services. Outlines reporting requirements and requirements for updating official documents that indicate name, sex and gender.
Background
Gender affirmation surgery refers to procedures done to help people transition to the other sex. This may include several procedures, including facial reconstructive surgery, vocal surgery, chest surgery or genital surgery. For individuals who choose to transition, surgeries can enhance or lessen physical characteristics of being a male or female, as well as make changes to the genitals. Surgeries associated with transitioning from female to male may include facial masculinization surgery, masculinizing top surgery, hysterectomy, vaginectomy, metoidioplasty, phalloplasty or scrotoplasty. Surgeries associated with transitioning from male to female include facial feminization surgery, feminizing top surgery, orchiectomy, penectomy, vaginoplasty or vulvoplasty (Cleveland Clinic).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Prohibits, beginning January 1, 2025, any contract that provides coverage for gender transition procedures issued, delivered or renewed by a health insurer from denying coverage for gender detransition procedures.
2. Requires a physician, health care institution or other person or entity authorized to provide health care services in Arizona and that performs gender transition procedures to agree to provide or pay for the performance of gender detransition procedures.
3. Requires a health insurer that provides coverage for gender transition services to submit a report to the Department of Insurance and Financial Institutions (DIFI) within 15 days of the end of the calendar month in which the claim for a detransition procedure was filed.
4. Requires the report submitted to DIFI to be on a form prescribed by DIFI that includes the:
a) number of insurance claims made for a gender detransition procedure;
b) age and sex of the individual who received the detransition procedure;
c) date the individual began a previous gender transition procedure, if known; and
d) state and county of residence of the individual who received the gender detransition procedure.
5. Prohibits the report submitted to DIFI from including information that would cause the individual who received a detransition procedure to be identified.
6. Requires DIFI to prepare an annual statistical report that compiles the information from the report submitted by the health insurer.
7. Requires DIFI make the statistical report available in a downloadable format and to submit the report to the Governor, President of the Senate, Speaker of the House of Representatives and to provide a copy to the Secretary of State.
8. Allows the Attorney General to:
a) investigate a violation of the outlined requirements and prohibitions;
b) seek production of documents or testimony through a civil investigative subpoena; and
c) bring an action to enforce compliance with the outlined requirements and prohibitions.
9. Requires any state agency that issues licenses, certificates, permits or official documents that require a name, sex or gender designation to adopt an expedited process to:
a) allow an individual who is in the process of a gender detransition procedure to update the individual's prescribed document accordingly;
b) provide a report to the Arizona Department of Administration (ADOA) with the current types of official outlined documents issued by the agency and the current process for updating the name, sex or gender designation on such documents by December 21, 2025; and
c) identify an expedited process for individuals in the process of a gender detransition to update their official documents accordingly and requires the state agency to provide a report to ADOA by June 30, 2026.
10. Repeals the requirements pertaining to state agencies that issue licenses, certificates, permits or official documents that require a name, sex or gender designation on January 1, 2027.
11. Defines health insurer.
12. Becomes effective on the general effective date.
Governor's Veto Message
The Governor indicates in her veto message that S.B. 1511 is unnecessary and would create a privacy risk for patients.
Senate Action House Action
HHS 2/13/24 DP 5-2-0 HHS 3/11/24 DP 5-4-0-1
3rd Read 2/22/24 16-12-2 3rd Read 6/4/24 31-29-0
Vetoed by the Governor 6/18/24
Prepared by Senate Research
June 21, 2024
MM/KS/slp