Colorado has become the first state in the country to include transition-related care for transgender people as part of the requirements for essential health care in the state, the Biden administration announced on Tuesday.
As part of the change, the Centers for Medicare & Medicaid Services approved the state’s request to provide gender-affirming care in the individual and small group health insurance markets as part of Colorado’s Essential Health Benefit benchmark.
Secretary of Health & Human Services Xavier Becerra said in a statement the change is consistent with the Biden administration’s goal of eliminating barriers faced by transgender people in access in health care, including transition-related coverage.
“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,” Becerra said in a statement. “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.”
According to HHS, Colorado plan will require insurers to cover a wider range of services for transgender people in addition to benefits already covered, such as eye and lid modifications, face tightening, facial bone remodeling for facial feminization, breast/chest construction and reductions, and laser hair removal.
In addition to these changes, Colorado s also adding EHBs in the benchmark plan to include mental wellness exams and expanded coverage for 14 prescription drug classes, according to the HHS. These changes, per HHS, will take effect beginning on Jan. 1, 2023.
CMS Administrator Chiquita Brooks-LaSure said in a statement health care should be “accessible, affordable and delivered equitably to all, regardless of your sexual orientation” (notably leaving out gender identity from that quote).
“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,” Brooks-LaSure said. “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.”
According to the Washington Post, Biden administration signed off on the change before officials made the announcement Tuesday in Denver in an event with Gov, Jared Polis, the first openly gay man elected governor in the United States.
Katie Keith, a lawyer and co-founder of Out2Enroll, is quoted in the Washington Post as saying despite the change significant issues remains for transgender people in health care.
“There’s been significant progress, but we’ve seen exclusions by some health plans — it got worse under the Trump administration — and that’s why it’s important to see states like Colorado stepping up to fill those gaps,” Keith is quoted as saying.