Transgender people have consistently been subject to health care coverage policies that arbitrarily cut off access to the care they need. State policymakers in Oregon, however, have recently stepped up to end this kind of discrimination. It is no secret that pervasive bias and discrimination have pushed transgender Americans to the margins of society. Health insurance coverage has been no exception. While many people are able to rely on health insurance coverage to offset some of the costs of both routine and emergency health care, insurers have frequently relied on outdated assumptions about transgender people in order to justify categorical exclusions—limitations and exceptions to services offered under a health insurance plan— denying them coverage for medically necessary care, even when those services are provided to other people enrolled in the plan. But recent motion toward coverage parity for transgender people at the state level shows that these barriers are not immovable. In fact, a close examination of the recent announcement by the Oregon Insurance Division that insurance companies doing business in Oregon must expand access to care for transgender people reveals that every state has the legal infrastructure to end antitransgender discrimination in health insurance—and that they can do it without passing a single new law. There are three kinds of statutes already on the books in some combination in every state that give policymakers the authority to end antitransgender discrimination in insurance: public-accommodations laws, prohibitions on unfair trade practices in insurance, and grants of discretionary authority to insurance regulators. Let’s examine in further detail how state policymakers can use these statutes to end this discrimination.
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