Starting in 2023, health insurance plans covering about one-quarter of the market in
The changes will affect plans sold on the individual and small group markets – so it won’t apply to people who get their insurance from large employers or government programs like Medicare.
Gender-affirming care is an umbrella term for services to transgender or nonbinary people, which can include hormone treatments, permanent facial hair removal, counseling, speech therapy, or surgery. Cisgender people sometimes also seek gender-affirming care, such as breast reconstruction after a mastectomy (though they may not think of it in those terms).
“Today marks the first time that a state has looked to add gender-affirming care as an essential health benefit,” said Chiquita Brooks-LaSurek, administrator of the federal
The state legislature would need to act in order to require large employers’ insurance plans to cover gender-affirming care.
Transgender people who have received gender-affirming care have lower rates of depression than those who were denied care, and are less likely to report thoughts of suicide.
“We know that gender-affirming care is vital to the mental health of transgender and nonbinary Coloradans,”
Colorado Insurance Commissioner
“I had to be convinced this will save more than
The requirement that plans cover an annual mental health check-up and alternatives to opioids came from bills passed in the most recent legislative session, which also require large-group plans to offer the same coverage. The gender-affirming care requirements came from an administrative process, with the
“For decades, we had a system that incentivized overprescribing,” she said. Doctors “often talk about, ‘This (opioid medication) is the only thing covered by insurance.’ That is unacceptable.”