Know Your Healthcare Rights

The Federal Employees Health Benefits (FEHB) Program, which includes the Postal Service Health Benefits (PSHB) Program, provides health insurance benefits to approximately 8.2 million federal employees, U.S. Postal Service employees and their eligible family members, as well as certain Tribal employees and their eligible family members. The U.S. Office of Personnel Management finalized benefit changes for plan year 2026.

• Key Gender-Affirming Care Exclusion: The recent changes remove coverage for “medical or surgical modification of sex traits, including gender transition procedures,” which the administration defines to include both gender-affirming surgery and hormone treatments, for all ages. This represents a significant policy change from 2025, when coverage was available for adults.

• Key Exceptions and Requirements:The FEHB Program Carrier Letter issued on August 15, 2025 noted that as an exception, counseling services for possible or diagnosed gender dysphoria must still be covered. Additionally, carriers must establish an exceptions process for enrollees who are mid-treatment within a surgical and/or hormonal regimen for diagnosed gender dysphoria.

The Department of Health and Human Services (HHS) has taken several steps to restrict gender-affirming care for minors.

In December, 2025, HHS Secretary Kennedy issued a declaration stating that procedures aimed at changing a child's physical appearance to match a gender identity different from their sex at birth — including puberty blockers, cross-sex hormones, and surgeries — are neither safe nor effective and do not meet recognized medical standards of care.

• In April, 2026, a Federal Judge in Oregon ruled that this declaration was unlawful. This means that HHS cannot use the declaration to take action against health professionals who provide gender-affirming care to youth.

Also in December 2025, the Centers for Medicare and Medicaid Services (CMS) put forward three proposed rules — meaning they are not yet final and are subject to public comment. Taken together, if finalized after the public comment period, the rules would significantly limit access to gender-affirming procedures for minors through federal programs:

• Hospitals participating in Medicare or Medicaid would be prohibited from performing these procedures on patients under 18 if they want to continue receiving federal funding.

• State Medicaid programs would lose federal matching funds for covering these procedures for patients under 19, though states could still choose to cover them using their own money.

• Gender dysphoria not linked to a physical condition would be explicitly excluded from disability protections under Section 504 of the Rehabilitation Act.

Read a summary of the declaration and proposed rules.

What does this mean for Illinois? These federal actions are not yet final and do not currently have any legal effect on services in Illinois. Illinois has legal protections for gender-affirming care. However, some hospitals and providers have chosen to preemptively pause or discontinue gender-affirming healthcare services in response to actions by the federal government. If your care is affected and you have questions about your legal rights, call the IL Pride Connect Legal Hotline at 855-805-9200.

U.S. v. Skrmetti is a Supreme Court case that was decided in June 2025. The case began as a legal challenge by three transgender adolescents, their families, and a medical provider against a Tennessee law banning gender-affirming hormone treatment for trans youth. The Supreme Court ruled that the Tennessee law was allowed to remain in effect in that state. The decision says that Tennessee's state ban on gender affirming care for youth is legal, but the decision does not outlaw gender affirming care in the US or impact states like Illinois that choose to protect gender affirming care for youth.

Why are some Illinois hospitals no longer providing gender-affirming care? It is not illegal to provide or receive gender affirming care, including gender affirming care for youth, in the state of Illinois. Some hospitals have chosen to stop providing this care to youth under 19, even though there is no legal ban on providing this care in Illinois. Reasons why hospitals and other providers may choose to stop providing this care include fears of being sued or of losing federal funding. If your care is affected or you are unsure about your access to services, call the IL Pride Connect Legal Hotline at 855-805-9200.

Illinois Medicaid is a health insurance program that provides affordable health insurance coverage to qualified Illinois residents.

• In Illinois, Medicaid covers gender-affirming care, including youth gender-affirming care. See Medicaid Basics, Services that are Covered by Medicaid, and Prescription Policy for Medicaid.

• You can call the IL Pride Connect Legal Hotline at 855-805-9200 if you have questions about Illinois Medicaid, like how to apply, what services are covered, or how to appeal a denial of coverage.

Private health plans in Illinois, including Affordable Care Act plans and many employer-based plans, may not exclude gender-affirming care or specific gender-affirming care services from coverage simply because it relates to gender transition. Insurance companies in Illinois cannot:

• Refuse to enroll you in a plan because you are trans

• Cancel your coverage because you are trans

• Charge you higher rates because you are trans

• Deny you coverage for treatment just because the gender listed on your insurance does not match the gender associated with a particular service

For more information on health insurance protections in Illinois:

• Illinois Department of Insurance (IDOI) Guidance to Insurance Companies on Trans Health Coverage Guidance‍ ‍

  • This guidance reminds health insurers that they cannot flatly refuse to cover medically necessary gender-affirming care — including surgeries — for people with gender dysphoria. Insurers must use up-to-date, evidence-based medical standards when deciding what care is medically necessary, and cannot use blanket exclusions to deny care that meets those standards. They also cannot label a treatment "experimental" if it aligns with current accepted medical practice. When coverage is denied, patients must still have access to an appeals process.

• For more information about health insurance discrimination, see the Advocates for Trans Equality Healthcare Know Your Rights page.

• If you have experienced an insurance denial of gender-affirming care, call the Illinois Pride Connect Legal Hotline at 855-805-9200 for assistance.