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Tuesday, March 14, 2006
Sex changes through the state a go again after policy reversal
By CHRIS McGANN
P-I CAPITOL CORRESPONDENT
OLYMPIA -- The Legislature is having trouble coming to terms with its feelings about taxpayer-financed sex-change operations.
Earlier this year lawmakers added a line to the budget to end the policy when reports based on a 2004 Medicaid audit revealed the state had paid for a sex-change operation and other questionable procedures such as penile implants.
The amendment, which read "no funds ... shall be expended upon gender reassignment surgery or treatment," passed with broad bipartisan support in the House and Senate, and supporters thought the matter had been resolved.
But as the Legislature adjourned last week, leading Democrats reversed themselves and axed the line when they met in a conference committee, which was closed to the public, to reconcile the details of their budget proposals.
House Appropriations Chairwoman Helen Sommers, D-Seattle, said the committee struck the amendment because it may have prohibited surgery for infants born with both male and female reproductive organs.
"That's more common than I thought," Sommers said. "I don't think we should be doing any gender surgery other than that, but I do think that this is appropriate."
Sommers said she was aware the state had paid for sex-change operations in the past.
"I don't think that's appropriate," she said.
Rep. Jim Clements, R-Selah, sponsored the amendment to the House budget.
He said he was disappointed this policy decision had been made in a committee that is not open to the public.
"I'm not going to argue if it's good or bad," Clements said. "Just make (the process) transparent so we can fairly debate these issues, not just let them die in a conference committee."
Clements said if Democratic leaders were concerned about hermaphrodite children, they could have rewritten the amendment to allow surgical intervention in those cases.
As it stands, the state could still use tax dollars for adult sex changes covered by Medicaid, the federal-state program that pays for health care for needy people.
State Medicaid Director Doug Porter has dismissed the sex-change surgery as a sensational issue that has very little effect on the agency.
"We're talking about a handful of people over a long period of time," Porter said.
In 2003 the department changed its approval policy for sex-change operations because the medical community determined medication and psychotherapy were as effective as surgery to treat the condition.
Now the agency insists patients try less costly and less severe interventions before it would approve a sex-change operation.
Clements said the 2004 Medicaid report highlighted many other issues including unauthorized cosmetic surgeries, health services provided for illegal aliens and other apparently fraudulent claims.
"I find it rather disconcerting," Clements said. "My attitude is, and I've said this to (Gov.) Christine Gregoire, you either get a hold of that agency or you're going to have a huge scandal on your hands."
Clements' prediction has already been realized on at least one count.
Last week, U.S. Sen. Charles Grassley, R-Iowa, chairman of the Senate Finance Committee, launched a federal inquiry into the state's Medicaid expenditures.
Gregoire responded to Grassley, saying in a letter Friday that a review of the expenditures in question showed they were allowed by the Medicaid program.
Jason Mercier, a budget analyst at the conservative think tank the Evergreen Freedom Foundation, said striking the amendment banning taxpayer-funded sex changes sends the wrong message to voters.
"It was odd timing," he said. The Legislature "passed this proviso in both bodies to address a problem that they knew was going to get Congress' attention and then they stripped it from their final budget."
P-I reporter Chris McGann can be reached at 360-943-3990 or firstname.lastname@example.org.
ほんの少し優先順位が変わればいいのに -minx 2006/03/15