Rep. Diana Harshbarger, R-Tenn., has introduced legislation that would require health insurance companies covering gender transition procedures to also provide coverage for detransition care and the treatment of adverse effects.
Dubbed the TRUTH in Coverage Act, the bill seeks to address concerns that individuals undergoing gender reassignment procedures face financial barriers when seeking to reverse them or manage complications. Harshbarger, who has a background in pharmacy, expressed that current insurance plans often cover gender-affirming surgeries but refuse to pay for restorative care, creating a financial burden for patients.
"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. That's not a fair deal for patients who want to restore healthy bodily function," Harshbarger stated. She added, "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 proposed legislation would amend federal statutes governing private health insurance, including the Public Health Service Act and laws related to employer-sponsored and group health plans. It would mandate that insurers cover necessary items and services to address complications or adverse effects stemming from gender transition procedures, irrespective of state or local mandates. The bill also aims to prevent insurers from altering copays, deductibles, or implementing treatment limitations related to such care.
If passed, the TRUTH in Coverage Act would take effect on January 1, 2027. It currently has 12 cosponsors. A similar bill was signed into law in Texas last year by Gov. Greg Abbott.
Texas Senate Bill 1257, sponsored by Sen. Bryan Hughes, highlighted the need for such coverage, noting that "many of these individuals require extensive medical care to manage or reverse the effects of previous treatments, yet they are frequently denied insurance coverage, leading to insurmountable out-of-pocket expenses." Hughes added that without this coverage, patients face significant health risks, including hormone imbalances, surgical complications, and psychological distress.
The bill's broad scope, including adverse effects, is intended to bypass technicalities in defining detransition. According to the National Library of Medicine, defining detransition can be complex, with indicators such as stopping hormones, reversing surgeries, or changing legal documents.
It remains unclear when or if Harshbarger's bill will be brought to the House floor for a vote. Legislation of this nature often faces opposition in the Senate.