Rep. Diana Harshbarger, R-Tenn., has introduced federal legislation that would compel health insurance companies to cover detransition procedures and the adverse effects of gender transition surgeries. The bill, titled the TRUTH in Coverage Act, aims to ensure that patients who undergo sex-reassignment procedures have their costs covered if they later seek to reverse those procedures or address resulting complications.
Harshbarger, who has a background in pharmacy, expressed concern that current insurance plans often create a financial barrier for individuals seeking to reverse gender transition treatments. "It's outrageous that a health plan can cover sex-rejecting procedures but refuse to cover the restorative care patients need to address the harm they cause," Harshbarger stated. "That's not a fair deal for patients who want to restore healthy bodily function."
The legislation, if passed, would take effect on January 1, 2027, and has garnered support from 12 cosponsors, including Rep. Buddy Carter, R-Ga.
The TRUTH in Coverage Act would amend three federal statutes governing private health insurance: the Public Health Service Act, employer-sponsored health plans, and group health plans. It would establish a uniform federal coverage requirement, preventing insurers from altering copays, deductibles, or imposing treatment limitations specifically to avoid covering detransition care or addressing adverse effects.
This federal effort follows a similar measure signed into law in Texas last year. Texas Gov. Greg Abbott enacted Senate Bill 1257, sponsored by Sen. Bryan Hughes, which addresses comparable concerns at the state level. Hughes's office noted in a statement that many individuals require extensive medical care to manage or reverse the effects of previous treatments but are often denied insurance coverage, resulting in substantial out-of-pocket expenses and significant health risks.
While precise numbers of detransitions are difficult to ascertain, as the process can involve stopping hormone therapy, reversing surgeries, or changing legal documents, Harshbarger's bill aims to provide broad coverage by including adverse effects. "Patients should never be abandoned after undergoing life-altering, harmful medical interventions once reality sets in," Harshbarger said. "As a pharmacist, I've seen insurance companies find every excuse in the book to avoid paying for the care patients actually need. My TRUTH in Coverage Act restores fairness, promotes transparency and ensures patients aren't left paying the price for care their insurance should cover."
The bill faces an uncertain path forward and is unlikely to pass the Democratic-controlled Senate. It is currently unclear when or if the legislation will be brought to a vote on the House floor.