MedicaidCoverageMedium impact
Changes to ACA Section 1557 do not affect Oregon Health Plan coverage of gender transition services
Oregon Health Plan·OR · Endocrinology, Psychiatry, OB-GYN +4 more·Plan
Effective date
Jun 25, 2020
We identified it
Jun 20, 2026
Summary
Oregon Health Authority clarifies that recent federal changes to ACA Section 1557 do not affect Oregon Health Plan (Medicaid) coverage for gender transition services. OHP will continue to cover hormone therapy, counseling, and surgeries for transgender members per existing state guidelines.
Action Required
Immediately: Coordinated care organizations and providers should continue billing gender transition services according to HERC Guideline 127 and Oregon state law. No changes to current billing practices are needed. For questions, providers should contact the member's CCO or OHP Provider Services at dmap.providerservices@dhsoha.state.or.us or 1-800-336-6016.