Who Needs Permission?

by Ellen Kolb

The Joint Legislative Committee on Legislative Rules voted today to accept a New Hampshire Department of Health and Human Services (DHHS) Medicaid rule change, providing coverage for gender-altering procedures.

Substance of the rule aside, what amazes me is the process by which it came about. The administrative side of government is the one I know least about, and sitting in the committee room today as the vote was cast was an eye-opener.

This rule change came to light when some folks on the New Hampshire Healthy Families insurance plan (Medicaid) got a letter from DHHS last July, announcing that procedures associated with “gender reassignment” would be covered. Done deal.

That was a few weeks before DHHS had a public hearing on a new Medicaid rule letting such coverage go into effect. Once DHHS had its hearing, the new rule went to JLCAR for today’s vote.

JLCAR has only a few legal grounds for rejecting a proposed rule, and apparently “putting a rule into effect before a public hearing” isn’t one of them.

Bureaucrats, learn from your DHHS peers: it’s better to ask forgiveness than permission. And sometimes you don’t even need to worry about forgiveness.

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