The passage of the Affordable Care Act—colloquially known as Obamacare—marked a victory in providing comprehensive, accessible health coverage to low-wage women. In 2014 the ACA is still advancing the rights for women, specifically transgender women with low-wage jobs.
Thanks to Obamacare, insurance companies are prohibited from denying health coverage based on pre-existing conditions. Prior to Obamacare, a diagnosis of gender identity disorder was enough to deny a transgender person health coverage since insurance companies classified the disorder as a pre-existing condition. Now, this diagnosis cannot be used as a justification to deny transgender people coverage. While this advancement is cause enough for celebration, Obamacare has taken another step towards removing discrimination from health coverage by allowing transgender women with low-wage jobs to use their more affordable health insurance to cover the costs of transgender surgeries and hormones.
Before Obamacare, sex affirmation surgery was accessible only to those few transgender people who could pay for the surgery and ancillary medical care out of pocket. Now that all transgender people are eligible for private insurance and Medicaid has expanded to cover more low-wage transgender people, transgender people have more control over their identities. Though not all transgender people desire sex affirmation surgery, they now have the ability to make the decision themselves.
Despite this major victory, the battle for full transgender rights is far from over. Transgender people must still fulfill extensive requirements to qualify for transition surgeries, sometimes including a diagnosis of gender identity disorder. The exact laws and guidelines can vary state-to-state, and federal law is far from clear on policies related to transgender people.