The XX Factor

Rep. Paul Broun Fears Obamacare Will Turn Him Female

A still-male Paul Broun greets Alec Baldwin

Photo by Paul Morigi/Getty Images for Ovation

Georgia Rep. Paul Broun received a flurry of headlines for a strange comment that seemed to imply that the Affordable Care Act will be requiring gender reassignment surgery for everyone, or perhaps just for congressmen from Georgia. As reported in the Huffington Post:

“I don’t want to pay for a sex-change operation,” Broun told town hall attendees, presumably referring to a proposal, scrapped by the Obama administration late last month, that would have allowed gender confirmation surgeries to be covered under Medicare and Medicaid. “I’m not interested. I like being a boy.”

The comment is being compared to a similar one made by Sen. Saxby Chambliss, to justify his opposition to same-sex marriage: “I’m not gay. So I’m not going to marry one.” Chambliss is also from Georgia, suggesting that perhaps Georgia needs to create a program educating its politicians about the difference between being allowed to do something and being forced to do it. 

Of course, while it’s always entertaining watching Republicans confuse the words can and must, the real story is being lost in the cackling coverage: Broun is running around Georgia lying to the voters about what the Affordable Care Act is all about. The original story reported in the Barrow County News puts these comments into context, saying that Barrow was criticizing the ACA for “covering hair transplants and sex change operations.” But there’s no way that the ACA could do that. The legislation is not like the National Health Services in Great Britain, where everyone is insured by a single payer run by the government. It’s a giant set of regulations that is aimed at making sure that most Americans are insured through private insurers.

It is true that under the ACA, insurance companies must meet minimum standards of coverage, but if that’s what Broun was referring to, then he’s still mistaken. The ACA’s language banning gender discrimination does seem to cover transgendered people, but the law specifically does not require gender reassignment surgery as minimum coverage. The HHS is blunt on this point:

Does this mean that transition related surgery is required to be covered by health insurers?


Of course, individual insurers can choose to offer this coverage if they want to, but that was true prior to the passage of the ACA. Under the Georgia conservative transitive property that turns can into must, therefore, Broun should have gotten his mandatory gender reassignment surgery decades ago.