New Analysis Shows that Marketplace Plans Continue to Be Better Than Ever for Transgender People

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Photo Credit: sarah-ji via Creative Commons

Regular Health Policy Hub readers know how important the Affordable Care Act is to improving the health and financial stability of millions of LGBTQ people across the country. Thanks to health reform, the uninsured rate for low- and middle-income LGBTQ people has fallen by an overwhelming 35 percent since 2014. More LGBTQ people have access to the health care they need (like substance use disorder treatment, HIV treatment, and mental health care), and critical nondiscrimination protections mean that LGBTQ people should no longer face discrimination in health insurance or health care simply because of who they are or who they love.

Although the Affordable Care Act and the LGBTQ community has been under attack in 2017, there is some good news when it comes to transgender health. As we near the end of this year’s open enrollment period (the final deadline is December 15th!), we’re happy to report that marketplace plans at continue to be better than ever for transgender people.

We know because we looked at 548 silver marketplace plans from 71 insurers in 18 states that use and found that, for the second year in a row, the vast majority of insurers no longer include discriminatory exclusions that target the medically necessary health care that many transgender people need to treat gender dysphoria. Key findings include:

  • Consistent with a similar analysis last year, the vast majority of insurers (90 percent) did not include transgender-specific exclusions in their 2018 marketplace plan options.
  • More insurers than ever before (28 percent) affirmatively stated that some or all medically necessary treatment for gender dysphoria is covered, an increase from 18.5 percent in 2017.
  • Fewer insurers (24 percent) had other types of exclusions—such as exclusions for certain procedures or overbroad “cosmetic” exclusions—that would limit access to medically necessary treatment for gender dysphoria, down from 55.5 percent of insurers in 2017.

To help transgender consumers better understand their options before the December 15th deadline, we compiled this information in 18 state-specific transgender health insurance guides with information about plans offered in Arizona, Florida, Georgia, Illinois, Louisiana, Michigan, Missouri, Nevada, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Virginia, West Virginia, and Wyoming. (The guides are a helpful start, but we urge all consumers to carefully review each plan to ensure it meets their needs and/or make an appointment with an LGBTQ-friendly enrollment assister who provide free help.)

Although there is still progress to be made, this analysis confirms that health insurance options for transgender consumers continue to be better than ever—despite the federal government’s efforts to sabotage the Affordable Care Act and roll back protections for LGBTQ people. The results also suggest that insurers acknowledge and understand that the gender-identity nondiscrimination protections under Section 1557 of the Affordable Care Act remain in force and that discriminating against transgender people is bad business.

With more insurers than ever before confirming that medically necessary care for transgender people is covered, there has never been a better time for transgender people to #GetCovered for 2018. As Valerie Jarrett and Mara Keisling recently put it in an op-ed for the Advocate, transgender people should “make a plan to get you and your family covered now, so you — and the rest of us — can keep fighting for the care we need.”

The final deadline to enroll in affordable health insurance through is December 15th. For more information on what this means for the transgender community, please visit

Katie Keith is a member of the Steering Committee at Out2Enroll