A Candid Warning for MN Parents and Caregivers of Transgender Children Considering Freelancing
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A Candid Warning for MN Parents and Caregivers of Transgender Children Considering Freelancing

by David Annis on Nov 29, 2023

For those of you contemplating the freelance life, particularly parents and caregivers of transgender children, I'd like to offer a candid and urgent warning. The freedom of freelancing comes with a rarely discussed but significant challenge: navigating a health insurance landscape that is not only complex but often pert near hostile, especially when it involves specialized medical treatments like hormone blockers.

The High Cost of Health Insurance

COBRA, while extending your employer's health insurance, can be prohibitively expensive. Turns out, employers spend a lot of money on healthcare for their employees. At least the one's care and can.

As an example, if our family wanted to continue using the healthcare benefits so generously offered by my former employee, we were looking at $2,500 per month. This is a daunting financial burden for anyone, especially for a freelancer whose income might fluctuate from month to month.

Affordable Alternatives? Think Again

The MnSure exchange might seem like a more affordable solution, offering plans for around $1,400 per month with similar coverage to our $2,500 per month plan. However, the system has its limitations and complexities that can be confusing and overwhelming.

State Medical Assistance: A False Hope?

"Free" MN State Medical Assistance feels a mirage in the desert for those freelancers just starting out with little to no income on day one. Yes, it’s free, but it's fraught with challenges. Treatments are often denied initially, necessitating a lengthy and stressful appeal process with no gaurantees.

A Critical Situation: Hormone Blockers for Transgender Children

For those with transgender children undergoing hormone blocker therapy, the situation is dire. The cost for a six-month injection is a staggering $50,000.

Under state insurance, this essential treatment is likely to be denied, even if your child is already getting injections. The appeal process is not just lengthy; it's a race against time. Missing a dose can mean puberty kicking back in, causing irreversible physical changes and immense psychological distress for the child, exacerbating feelings of stigma, "otherness", and hopelessness.

The Supplemental Insurance Myth

Side note: Even if you opt to purchase supplemental insurance, strange obstacles remain. For example, dental providers are often reluctant to accept patients with supplemental dental insurance if they are on state medical insurance. I assume this is because they don't want to run the risk of needing to deal with Medical Assistance should a dental procedure result in needing medical care.

The Inaccessibility of Direct Insurers

Another odd realization is that being eligible for Medical Assistance excludes you from using the MnSure marketplace, leading you to more expensive direct insurers for any additional insurance coverage. For many, this is not a viable option.

Conclusion: A Wake-Up Call to Action

This is a wake-up call for not just parents and caregivers of transgender children but for all of us. The current healthcare system, with its labyrinthine complexities and exclusions, particularly in the context of transgender healthcare, is failing our families. We need to demand drastic changes in our healthcare policies and systems. It's time for healthcare to be truly inclusive, affordable, and accessible for all, irrespective of one's employment status or the specific medical needs of their children.

Your Voice Matters

I urge you, especially those who have faced or are facing these challenges, to speak up. Share your stories, join advocacy groups, and let your representatives know that the current system is untenable. Together, we can fight for a healthcare system that acknowledges and supports the needs of every individual, including the most vulnerable among us.

For those looking to take action in healthcare reform, particularly in Minnesota, there are several resources and groups that you can engage with:

  1. Minnesota State of Reform Health Policy Conference: This conference, taking place at the InterContinental Saint Paul Riverfront Hotel on December 7, 2023, is an excellent opportunity to connect with leaders and policymakers in health reform. It's a platform where various stakeholders in the healthcare system convene to discuss policy changes and reform initiatives​.

  2. Health Care for All Minnesota (HCA-MN): This organization advocates for healthcare justice, focusing on a single-payer system, Improved and Expanded Medicare for All. HCA-MN is an influential group in Minnesota’s healthcare scene and has been recognized for its leadership and advocacy in healthcare reform​.

  3. Advocates for Better Health (ABH): Previously known as the Twin Cities Medical Society, ABH focuses on advancing the health of Minnesota communities and promoting physician well-being. They are involved in various public health initiatives and support physicians throughout their careers, from pre-med to retirement. Their work encompasses healthcare advocacy, making them a valuable resource for those interested in healthcare reform​.

  4. Minnesota Medical Association: This organization is dedicated to making Minnesota the healthiest state and the best place to practice medicine. Their advocacy efforts are aimed at improving patient and population health, health equity, physician satisfaction and well-being, and empowering physicians. This makes them a key player in healthcare reform advocacy​.

  5. Minnesota Mental Health - LGBTQ Advocacy: While this organization primarily focuses on mental health, their advocacy includes ensuring the best care possible, which can be critical in the context of healthcare reform. They encourage speaking up, making informed decisions, demanding respect, and fighting for healthcare causes​.


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