Insurance Protections for Transgender People

On May 12, 2021, Gov. Inslee signed SB 5313 into law, prohibiting health insurers from discriminating against policyholders by denying medical necessary treatment, regardless of their gender expression or identity. The new law comes alongside the Biden administration’s decision to enforce ACA Section 1557 in accordance with the Supreme Court’s Bostock decision.

The new law indicates that individual and small group health insurance plans (including plans on the state exchange) issued on or after January 1, 2022, cannot:

  • Deny or limit coverage for gender-affirming treatment when it is medically necessary and prescribed by a medical professional
  • Apply categorical cosmetic or blanket exclusions to gender-affirming treatment

Although this law applies to insurers, employers should familiarize themselves with it as it will apply to any plan participants enrolled on plans to which the law applies.

SB 5313 »