Hastings Journal on Gender and the Law


Kate Walsham


The Patient Protection and Affordable Care Act, is the most sweeping change to the U.S. healthcare system since 1965. It creates the perfect platform from which to improve access to medical care for transgender people. In 2005, California enacted a first-of-its-kind bill, the Insurance Gender Nondiscrimination Act, which prohibits discrimination on the basis of gender and gender identity in insurance coverage. This bill should be the model for federal regulations as the Patient Protection and Affordable Care Act’s provisions go into effect. This note advocates for enactment of a federal Insurance Gender Nondiscrimination Act based on California’s bill and the California Department of Insurance regulations, enacted in September 2012, which provide enforcement of the California Insurance Gender Nondiscrimination Act. Enacting a federal law based on the California law would secure explicit protections for gender-confirming and gender-incongruent procedures while simultaneously being pragmatic and increasing efficiency in healthcare overall.