“These proposed rules have the potential to increase fairness and access in health care for many, many people across the country, but they could be lifesaving for transgender people,” said Harper Jean Tobin, director of policy at the National Center for Transgender Equality. “There’s a medical consensus that transgender care is medically necessary and should be covered.”

Under the government proposal, insurers also can’t restrict services based on gender identity. For instance, insurers would still be required to pay for a medically necessary ovarian cancer treatment for someone who identifies as a man, the health department said.

Ten states and Washington, D.C., already prohibit insurance exclusions for transgender health care, according to Tobin’s group.

The rules proposed Thursday also require health-care providers to take more steps to communicate with people who don’t speak English or who have disabilities. And they prohibit marketing practices in health-care marketplaces and insurance benefit designs that are discriminatory.

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