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Biden administration okays gender affirming care requirement for Colorado health plans

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On Tuesday, Oct. 12, the Biden administration announced approval for gender-affirming care in the individual and small group health insurance markets as part of Colorado’s Essential Health Benefit (EHB) benchmark.

The U.S. Department of Health and Human Services (HHS) said the benchmark would improve access to coverage for gender-affirming care that meets individual needs and discourages the use of a “one-size-fits-all” framework for transgender people.

“Health care should be in reach for everyone; by guaranteeing transgender individuals can access recommended care, we’re one step closer to making this a reality,” said HHS Secretary Xavier Becerra in a press release. “I am proud to stand with Colorado to remove barriers that have historically made it difficult for transgender people to access health coverage and medical care.”

Gender-affirming care is considered a standard level of care by the American Medical Association, the American Academy of Family Physicians, and the American Psychiatric Association. Transgender patients often face discriminatory hurdles in accessing medically necessary health care services that affirm gender identity.

“Health care should be accessible, affordable and delivered equitably to all, regardless of your sexual orientation. To truly break down barriers to care, we must expand access to the full scope of health care, including gender-affirming surgery and other treatments, for people who rely on coverage through Medicare, Medicaid & CHIP and the Marketplaces,” said CMS Administrator Chiquita Brooks-LaSure. “Colorado’s expansion of their essential health benefits to include gender-affirming surgery and other treatments is a model for other states to follow and we invite other states to follow suit.”

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