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S 9275

Requires Medicaid to cover gender-affirming care regardless of federal funding; prohibits discriminatory practices by health care entities and insurers; relates to coverage for treatment for gender dysphoria

2025 Regular Session Introduced by Erik Bottcher and 6 co-sponsors

Expands Medicaid and private insurance to cover all medically necessary gender-affirming care and bans discrimination based on gender identity or gender dysphoria/gender incongruen

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Bill Summary · S 9275

Summary of Bill S. 9275-A (2025-2026) – New York

Proposed legislation aiming to expand Medicaid coverage for gender-affirming care, prohibit discriminatory practices by health care entities and insurers, and ensure coverage for treatment of gender dysphoria or gender incongruence.

1) Purpose and intent

  • Ensure that Medicaid covers all medically necessary gender-affirming care regardless of whether federal funds are available for such coverage.
  • Prohibit discriminatory practices by health care entities and by health insurers related to gender identity, gender expression, or gender dysphoria/gender incongruence.
  • Require broad coverage of gender dysphoria/gender incongruence treatment across private and public health insurance.

2) Key provisions and changes

A. Medicaid coverage (Social Services Law)

  • Adds a new provision stating: “all medically necessary gender-affirming care regardless of whether any federal funds are available for such coverage.”
  • This expands Medicaid coverage to include gender-affirming care irrespective of federal funding status.

B. Public health law – definitions of covered health care services

  • Expands the list of “covered health care services” to explicitly include all gender-affirming care, defined by the commissioner, and to be reimbursed under state rate-setting methodologies for related services (e.g., mental health, addiction, youth services, etc.).
  • Clarifies that coverage applies whether or not federal funds are available.
  • Excludes erectile dysfunction drugs/procedures for certain individuals (e.g., sex offender-related restrictions) but preserves denial-notice rights and information for challengers.

C. Executive Law – discriminatory practices by health care entities

  • Adds protections prohibiting discrimination by health care entities (hospitals, clinics, providers) against individuals based on gender identity or expression.
  • Amends prohibitions related to place-of-public-accommodation discriminatory practices to include gender identity/expression.

D. Insurance Law – discriminatory practices by insurers and coverage for gender dysphoria/gender incongruence

  • Adds protections against discrimination by insurers based on sex, gender identity or expression, gender dysphoria/gender incongruence, pregnancy, pre-existing conditions, etc.
  • Prohibits denial or reduction of coverage for gender dysphoria/gender incongruence.
  • Prohibits designating gender identity/gender dysphoria as a pre-existing condition to deny coverage.
  • Prohibits denying claims for services typically provided to a gender different from the insured, without reasonable steps to determine eligibility.

E. Insurance policy-specific requirements for gender dysphoria/gender incongruence

  • Requires health insurance policies that provide hospital, surgical, or medical coverage to include coverage for medically necessary treatments for gender dysphoria/gender incongruence.
  • Ensures such coverage is not subject to annual deductibles or coinsurance, except that high-deductible health plans may apply deductibles per federal tax rules.

F. Severability and effective date

  • Includes standard severability clause.
  • Takes effect immediately upon enactment.

3) Who/what would be affected

  • Medicaid recipients in New York would gain expanded access to all medically necessary gender-affirming care, regardless of federal funding status.
  • Health care entities (hospitals, clinics, and other providers) would be barred from discriminatory practices based on gender identity/expression.
  • Health insurers operating in New York would be prohibited from discriminatory practices related to gender identity and would be required to cover gender dysphoria/gender incongruence treatments without annual deductibles or coinsurance (subject to high-deductible plan rules).
  • Individuals seeking coverage for gender-affirming care or treatment for gender dysphoria/gender incongruence would see improved access and protections in both Medicaid and private insurance contexts.

4) Procedural and timeline aspects

  • Introduced in the Senate on February 23, 2026.
  • Referred to Health, then Finance; reported favorably from Health and then committed to Finance; amended and reprinted as S. 9275-A.
  • Action history indicates a rapid committee process with amendments and recommitment.
  • Effective date: immediate upon enactment.

5) Notable details

  • The bill codifies “all medically necessary gender-affirming care” in Medicaid irrespective of federal funds.
  • It broadens the category of “health care entities” and “covered health care services” to explicitly include gender-affirming care.
  • It strengthens anti-discrimination protections in places of public accommodation and in insurance coverage related to gender identity and gender dysphoria/gender incongruence.
  • It explicitly protects utilization review appeal rights for gender dysphoria/gender incongruence treatments denied on medical necessity grounds.

This summary highlights the bill’s core aims: broaden access to gender-affirming care, prohibit discriminatory practices by medical providers and insurers, and ensure comprehensive coverage for treatment of gender dysphoria or gender incongruence.

Compiled from official sources — confirm details with the bill’s official record.

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