Affordable Care Act Case Study

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The landscape for transgender healthcare has been radically impacted by the passage and implementation of the Affordable Care Act [ACA]. The ACA paved the way for the state and country to address the discrimination and barriers to accessing care that many transgender people have experienced. Over the past few years there have been significant changes to trans-specific healthcare coverage, which can be attributed to the clarification of Senate Bill 2 and the state and federal mandates. In this paper I will discuss the laws more in-depth, how they affect Kaiser Permanente specifically, and some recommendations on how to support fully inclusive healthcare.

Background
In 2007 a law to ban discrimination on the basis of sexual orientation and gender
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The tide began to turn for the federally funded programs in 2015, when the Oregon Health Plan [OHP] approved the treatment for gender dysphoria as a covered service. OHP moved Gender dysphoria treatments - including puberty suppression, cross hormone therapy and sex reassignment surgery [SRS], above the funding line. This was a controversial issue for some politicians who questioned the use of taxpayer money to support this. However others saw it as a historic step forward toward fairness and equality for transgender Oregonians.

Oregon is now one of fifteen states that prohibit exclusions of transition related health care for state employees. The influence on federal employees came early in 2016, when the Obama administration ordered federal employee health insurers to include transition-related health coverage for transgender employees in their plans. This was monumental - as the federal government is the largest employer in the country, with more than four million employees (and over 70,000 in

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