This story was originally reported by Orion Rummler of The 19th, and republished through Rewire News Group’s partnership with The 19th News Network.

Health-care costs for transgender Americans could increase starting in 2026, if a recently proposed rule from the Centers for Medicare & Medicaid Services (CMS) is finalized.

The agency wants to stop insurance sold on the individual and small-group marketplace from including gender-affirming care—a change that would affect coverage for trans people with marketplace plans. Doing so means that insurers could drop coverage for trans people entirely or that trans patients could see higher out-of-pocket costs, experts say.

Although the rule would not ban coverage of gender-affirming care outright, it would disrupt care for a vulnerable population that faces disproportionate risks of living in poverty, being low-income and having greater medical needs.

The proposed rule would affect “essential health benefits,” services that individual and small-group marketplace plans are required to cover. Essential health benefits refer to basic care, like hospitalization, mental health services and prescription drugs, as mandated by the Affordable Care Act. Under the proposed CMS rule, insurers would be barred from covering those services as essential health benefits when........

© Rewire.News