The largest employer health benefits program for the federal government announced a last-minute policy change on Friday that it would no longer cover gender-affirming care for adults next year, HuffPost has learned.
This directive, which was quietly issued by the U.S. Office of Personnel Management’s health care program, is the latest policy to target access to health care for transgender federal workers. A link to the change was first cited on a blog by Ermer & Suter, a Washington, D.C., law firm that represents federal health insurance plans.
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The policy change, signed by Associate Director of Healthcare and Insurance D. Shane Stevens, expands upon a similar directive issued by the agency at the end of January to block such care for minors up to age 19 on federal plans.
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President Donald Trump’s Week 1 executive order blocking federal funds from hospitals that provide gender-affirming care to children also included a provision to exclude that same coverage from both the Federal Employee Health Benefits and Postal Service Health Benefits programs. The administration finalized a rule in June to modify the Affordable Care Act, removing requirements that insurance providers cover gender-affirming care as essential, which advocates say will decrease the number of plans that cover that care.
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Under this letter, which was sent out to FEHB and PSHB carriers on Friday according to David Ermer, an attorney with Ermer & Suter, insurance companies that contract with the federal government will begin prohibiting coverage for transgender adults in 2026.
“For Plan Year 2026, chemical and surgical modification of an individual’s sex traits through medical interventions (to include ‘gender transition’ services) will no longer be covered under the FEHB and PSHB Programs. This exclusion expands upon Carrier Letter 2025-01a and applies regardless of age,” the letter states.
The Office of Personnel Management did not immediately respond to HuffPost’s request for comment.
In July, the House Appropriations Financial Services and General Government Subcommittee also released a draft of a funding bill that would further codify the prohibition, barring funds provided to FEHB from covering “the cost of surgical procedures or puberty blockers or hormone therapy for the purpose of gender affirming care.” The bill was sent to the full Committee on Appropriations, which will have a hearing to discuss various bill provisions next month.
The FEHB program provides benefits to more than 8 million federal employees and their families, and includes nearly 2 million postal employees under the PSHB program.
The Williams Institute, an LGBTQ+ policy research center, estimates that there are around 14,000 transgender federal employees, though not every trans person may pursue hormones or surgical treatments. Under this directive, all transgender adult federal employees and retirees, and trans children of federal workers would be denied coverage of gender-affirming care under the federal insurance plan.
OPM notes an exception for covered “counseling services for possible or diagnosed gender dysphoria” and “may include those who provide faith-based counseling.”
In May, the Department of Health and Human Services released a 409-page review of transgender health care, promoting “psychotherapy” as a “noninvasive” alternative to puberty blockers and hormone treatments for transgender youth.
LGBTQ+ advocates denounced this as rebranding conversion therapy, a dangerous and long-discredited practice built on the belief that being gay or trans is an illness to be cured.
Counseling and mental health services, especially those that are faith-based, contradict decades of scientific research on the benefits of gender-affirming care for alleviating gender dysphoria along with high rates of anxiety and depression.
The letter states that insurance provider directories must also remove mention of health care providers and clinics that offer gender-affirming care services. Coverage for patients that are already taking hormone therapy or undergoing surgery will be applied on a “case-by-case basis,” the letter states.
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Earlier this month, a senior Trump official told the National Review that the Centers for Medicare and Medicaid Services will introduce a proposal to ban hospitals that provide gender-affirming care to youth from receiving Medicare and Medicaid reimbursements. If proposed, this could be one of the largest attempts to ban gender-affirming care for youth nationwide.
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