Interesting

It's interesting that last fall the Secretary of Health and Human Services (HHS), the federal agency overseeing the Affordable Care Act (ACA), sent a letter to health insurance companies stating that they can't discriminate against transgender people, but it has caveats.

One caveat is that the letter which covered transgender under the ACA only stated the companies can't deny them coverage or reject claims for their healthcare with one exception, which is that the insurance companies aren't mandated to cover transition care, essentially therapy, drugs, and most importantly surgeries.

In other words, you have to take them as customers and cover the healthcare as you would anyone but you can discriminate against them for their transition care. This is the same as the Federal Employees Health Benefit (FEHB) program where companies can't deny employees or retirees who are transgender but they can deny them their transition care.

This is expressly stated in all the health insurance plans in the FEHB which does not cover "sex transformation" care and can recoup any care they did cover if they discover it was related to the patient's care for their transition outside of the normal healthcare for everyone else.

So, in the end, it really doesn't matter if you're transgender under the ACA or FEHB, the latter explicitly exempt from the ACA because it's the federal government, you still have to pay out of pocket unless you're fortunate to have an employer, attend a university or live in a state which does cover transition care under supervision.

Gee, not such a warm and fuzzy feeling. The insurance companies can't discriminate on one hand accepting you as a customer but then can discriminate on the other because you're a patient. So much for the ACA being useful.

And forget being under the FEHB because the White House sent a letter to the Office of Personnel Management (OPM) which oversees the FEHB program three years ago to remove the exclusive exemption from FEHB plans but have yet to do so.

So for transgender people, it's still the same, don't tell them you're transgender and get out your checkbook for your treatment and surgeries. Nothing's changed.