*Notes (see also the "Citations & More Information" tab or link below the map legend for more info about every state):  
--In Hawai`i and West Virginia, the state Medicaid policy is unclear. Hawai`i has a law banning gender identity discrimination in health insurance and banning exclusions of gender-affirming care, but the state also has a pre-existing regulation that explicitly excludes gender-affirming health care from being covered or paid for by the state Medicaid program. West Virginia had a court ruling that overturned its previous exclusion of transgender-related care, but the state is appealing that decision. See the "Citations" tab for more information.
--Idaho has no explicit policy, but a 2022 court case against the state shows that at least some transgender people on Medicaid have been denied coverage for transgender-related care. See the "Citations" tab for more information. 
--Ohio policy explicitly excludes transgender-related care, but as of mid-2019, The Washington Post and Bloomberg News both report that state officials say they are not enforcing the exclusion. See the "Citations" tab for more information.
--In Louisiana and Utah, the states have no explicit policy, but TLDEF reports that the individual health organizations that operate Medicaid in the state each have inclusive policies for covering transgender-related care.

For further information and details, please also visit the Transgender Legal Defense & Education Fund (TLDEF)'s Trans Health Project resources and research.

Federal law prohibits discrimination in health care on the basis of gender identity. Under Section 1557 of the Affordable Care Act (ACA), health facilities, programs, and activities receiving federal funding may not deny insurance coverage or care on the basis of, among other things, sex and gender identity and expression. This means several things for transgender people. First, sex-specific care cannot be denied simply because someone identifies as another gender. For example, a transgender man could not be denied care for ovarian cancer if such care is medically necessary. Second, “blanket bans” on all transition-related care are considered discriminatory, though some transition-related care can still be denied on a case-by-case basis. Finally, transition-related care that would be approved were it not related to transition cannot be denied.

If you have experienced discrimination in health care, you can file a complaint with the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services within 180 days of when the discrimination occurred. OCR also investigates violations involving the improper disclosure or use of your private medical information.

Recommended citation:
Movement Advancement Project. "Equality Maps: Healthcare Laws and Policies: Medicaid." https://www.lgbtmap.org/equality-maps/healthcare/medicaid. Accessed 05/30/2023.