Rep. Diana Harshbarger, a Tennessee Republican and pharmacist, has introduced legislation that would force health insurance companies to cover the costs of detransitioning and treating complications arising from transgender procedures if they already cover those procedures. The bill, known as the TRUTH in Coverage Act, aims to address what Harshbarger describes as a financial one-way door for patients who regret sex-reassignment surgeries or experience adverse effects.
Harshbarger argued that current insurance practices leave patients stranded after undergoing life-altering treatments. “It’s outrageous that a health plan can cover sex-rejecting procedures but refuse to cover the restorative care patients need to address the harm they cause,” she said in a statement. “That’s not a fair deal for patients who want to restore healthy bodily function.” The bill would require insurers to cover items and services needed to address complications or adverse effects resulting from such procedures, regardless of state or local laws that mandate coverage for the initial treatments.
The legislation would amend three federal statutes governing private health insurance: the Public Health Service Act, employer-sponsored health plans, and group health plans. It would also prevent insurers from adjusting copays, deductibles, or imposing treatment limitations on the required coverage. If enacted, the law would take effect on January 1, 2027.
The bill has 12 cosponsors, including Rep. Buddy Carter of Georgia, a former chairman of the Energy and Commerce Subcommittee on Health. Despite this support, the measure faces an uphill battle in the Senate, where Democratic opposition is expected to block its passage. However, the bill draws attention to a growing number of patients who have regretted sex-reassignment procedures and the barriers they face in addressing the fallout.
Texas Governor Greg Abbott signed a similar state-level law last year, reflecting a broader concern among conservative lawmakers. Texas Senator Bryan Hughes, who sponsored Senate Bill 1257, argued that many individuals require extensive medical care to manage or reverse the effects of previous treatments but are frequently denied insurance coverage, leading to insurmountable out-of-pocket expenses. “Without this coverage, patients face significant health risks, including hormone imbalances, surgical complications, and psychological distress,” Hughes wrote in a statement.
Determining the exact number of detransitioners is challenging, according to the National Library of Medicine. Researchers note that stopping hormones, reversing surgeries, or changing legal documents could all be triggers for what it means to begin the detransition process. By casting a wide net and including adverse effects, Harshbarger’s bill would circumvent those technicalities, ensuring that patients are not abandoned after undergoing what she called “life-altering, harmful medical interventions once reality sets in.”
Harshbarger, drawing on her experience as a pharmacist, criticized insurance companies for finding excuses to avoid paying for necessary care. “My TRUTH in Coverage Act restores fairness, promotes transparency, and ensures patients aren’t left paying the price for care their insurance should cover,” she said. It remains unclear when or if the bill will reach the House floor for a vote.