Maryland’s House health committee holds hearing on legislation to protect gender-affirming care


James Sklar


On Jan. 25th, Del. Anne Kaiser (D -Silver Springs) introduced House Bill 283, also known as Trans Health Equity Act. The bill would require Maryland’s Medicaid program to cover gender-affirming treatment in a nondiscriminatory manner.


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On Feb. 14th, Kaiser spoke to the House Health and Government Operations Committee regarding HB 283, on which she collaborated with Maryland’s Department of Health and medical professionals at John Hopkins, MedStar Health, and Chase Brexton. Kaiser stated that Maryland Medicaid currently denies coverage for 31 gender-affirming healthcare procedures, and said HB 283 would improve Maryland’s standard of care.

“It’s’ not just me sponsoring this bill, I am joined by 56 of my colleagues as co-sponsors,” Kaiser said. “More than a dozen of my colleagues also said they will be providing support, and there are countless other people and orgs providing supportive testimony.”

For the purposes of this bill, “gender-affirming treatment” means any medically necessary treatment consistent with current clinical standards prescribed by a licensed healthcare provider for the treatment of a condition related to the individual’s gender identity.

Gender-affirming treatment may include hormone therapy; hormone blockers; puberty blockers; and alterations to either hair, voice, body, face, or genitals. Under the proposed program, recipients who identify as transgender, nonbinary, intersex, two-spirit, or any other gender-diverse individuals would be reimbursed for gender-affirming treatment. 

Sam Williamson, staff attorney with Disability Rights Maryland, spoke in favor of HB 283, saying how federal courts have ruled that excluding coverage for gender dysphoria violates the ACA and federal Medicaid regulations, which should prompt Maryland to address this issue and bring the state into compliance. Williamson explained that, if passed, this bill would cost one half of 0.01% of Maryland’s Medicaid budget because all of the procedures in the bill would be federally reimbursable.

More than a dozen advocates spoke about the positives of the bill while the bill’s sponsors on the panel fielded multiple questions from members on the committee regarding who can utilize these services. Since private insurance in the state already covers gender-affirming care, the sponsors of the bill explained that HB 283 would essentially provide similar coverage to Maryland’s Medicaid recipients. 

“No doubt this is a big, complex issue for transgender people and their families to grapple with, and no one here takes it lightly,” Kaiser said.

Three people testified against the bill, including Jonathan Alexandre, attorney for the Maryland Family Institute, who argued that human bodies are naturally created to grow and thrive, and it is unjust to use puberty blockers on adolescents. 

Last session, Kaiser introduced this exact bill in the form of HB 746, which only had one hearing and failed to reach the House floor for a vote. HB 746’s Senate counterpart, Senate Bill 682, passed in the Senate with 31 “yes” votes to 15 “no” votes with one member not voting. Since the Trans Health Equity Act of 2022 never made it out of the House, it  died as the legislative session ended.

Nevertheless, Maryland has a Democratic trifecta government this legislative session, and sponsors and advocates of this bill noted that the governor is in favor of it, which will likely lead to its passage. HB 283 heads to the House’s Public Health and Minority Health Disparities Subcommittee for further debate, while SB 460, HB 283’s Senate counterpart, heads to its first hearing in the Senate Finance Committee.