More than 70 LGBTQ+, civil rights, health care access and reproductive freedom organizations across New York State are backing legislation designed to preserve insurance coverage for gender-affirming care amid ongoing federal policy changes that advocates say could limit access to treatment, according to the Legal Aid Society.
The proposal would require insurers to continue covering medically necessary gender-affirming services even if federal funding rules, guidance, or enforcement priorities shift, strengthening existing state-level protections tied to health coverage and nondiscrimination.
In a letter supporting the measure, the coalition cites recent federal actions affecting transgender and gender non-conforming communities, including executive orders, the rollback of Biden-era guidance interpreting anti-discrimination protections under the Affordable Care Act and a proposed federal rule that could restrict Medicaid funding for gender dysphoria treatment for people under 19.
The letter states:
“The Trump administration is waging an attack on New York State’s health care system with a target on the health care of transgender and gender non-conforming (TGNC) people. The attacks include a day one attempt to erase the existence of TGNC people with illegal executive orders, the rescission of Biden- era guidance clarifying that the Affordable Care Act’s section 1557 prohibits discrimination on the basis of gender identity and a current proposed rule that would eliminate federal funding for Medicaid coverage for the treatment of gender dysphoria for people under age 19.”
The organizations are urging legislative leaders in New York State to advance the bill this session, arguing that delays could create gaps in coverage for residents whose care is considered medically necessary by providers.
If enacted, the legislation would amend state Social Services Law to require continued Medicaid coverage for gender-affirming care regardless of federal funding availability. It would also amend Insurance Law to prohibit coverage denials for gender dysphoria treatment when comparable services are covered for other medical conditions and clarify that the state’s Human Rights Law applies to health insurance providers.
Supporters are calling on state legislative leaders to move the bill forward to ensure continued access to gender-affirming health care under state law.
