In 2012, California became the first state to ban the widespread insurance practice of line-item exclusions for transition-related care. Since then, departments regulating health insurance in 15 more states have issued statewide non-discrimination bulletins, which eliminate the discriminatory practice of line-item exclusions for all transition-related care. Some states, like California, have issued follow-up statements clarifying that no treatments can be categorically excluded, and that insurers must consider the medical necessity for each patient on a case-by-case basis.
In 10 states, Medicaid programs have explicit non-discrimination protections as well (California, Connecticut, the District of Columbia, Illinois, Massachusetts, Maryland, New York, Oregon, Vermont, and Washington).
In May 2016, the federal Department of Health and Human Services issued regulations on section 1557 of the Affordable Care Act, which is the non-discrimination section. These regulations included specific, detailed language that says discrimination based on gender identity is illegal under federal law. To read more about what this means for you, check out our fact sheet.
To understand how these bulletins can help you, check out our guide to appealing health care denials.