Amd §365-a, Soc Serv L; amd §292, Exec L; amd §§3243, 4303, 3221 & 3216, Ins L
Requires Medicaid to cover gender-affirming care regardless of federal funding; prohibits discriminatory practices by health care entities including hospitals, certain professionals, and insurers; requires insurance coverage for services or treatments for gender dysphoria or gender incongruence.
STATE OF NEW YORK
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9275
IN SENATE
February 23, 2026
___________
Introduced by Sen. RIVERA -- read twice and ordered printed, and when
printed to be committed to the Committee on Health
AN ACT to amend the social services law, in relation to requiring Medi-
caid to cover gender-affirming care regardless of federal funding; to
amend the executive law, in relation to prohibiting discriminatory
practices by health care entities; and to amend the insurance law, in
relation to prohibiting discriminatory practices by insurers and to
coverage for treatment for gender dysphoria or gender incongruence
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 2 of section 365-a of the social services law
2 is amended by adding a new paragraph (oo) to read as follows:
3 (oo) all medically necessary gender-affirming care regardless of
4 whether any federal funds are available for such coverage.
5 § 2. Subdivision 9 of section 292 of the executive law, as amended by
6 chapter 89 of the laws of 2015, is amended and a new subdivision 43 is
7 added to read as follows:
8 9. The term "place of public accommodation, resort or amusement" shall
9 include, regardless of whether the owner or operator of such place is a
10 state or local government entity or a private individual or entity,
11 except as hereinafter specified, all places included in the meaning of
12 such terms as: inns, taverns, road houses, hotels, motels, whether
13 conducted for the entertainment of transient guests or for the accommo-
14 dation of those seeking health, recreation or rest, or restaurants, or
15 eating houses, or any place where food is sold for consumption on the
16 premises; buffets, saloons, barrooms, or any store, park or enclosure
17 where spirituous or malt liquors are sold; ice cream parlors, confec-
18 tionaries, soda fountains, and all stores where ice cream, ice and fruit
19 preparations or their derivatives, or where beverages of any kind are
20 retailed for consumption on the premises; wholesale and retail stores
21 and establishments dealing with goods or services of any kind, dispen-
22 saries, clinics, hospitals, health care entities, bath-houses, swimming
23 pools, laundries and all other cleaning establishments, barber shops,
24 beauty parlors, theatres, motion picture houses, airdromes, roof
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD14310-02-6
S. 9275 2
1 gardens, music halls, race courses, skating rinks, amusement and recre-
2 ation parks, trailer camps, resort camps, fairs, bowling alleys, golf
3 courses, gymnasiums, shooting galleries, billiard and pool parlors;
4 garages, all public conveyances operated on land or water or in the air,
5 as well as the stations and terminals thereof; travel or tour advisory
6 services, agencies or bureaus; public halls, public rooms, public eleva-
7 tors, and any public areas of any building or structure. Such term shall
8 not include kindergartens, primary and secondary schools, high schools,
9 academies, colleges and universities, extension courses, and all educa-
10 tional institutions under the supervision of the regents of the state of
11 New York; any such kindergarten, primary and secondary school, academy,
12 college, university, professional school, extension course or other
13 education facility, supported in whole or in part by public funds or by
14 contributions solicited from the general public; or any institution,
15 club or place of accommodation which proves that it is in its nature
16 distinctly private. In no event shall an institution, club or place of
17 accommodation be considered in its nature distinctly private if it has
18 more than one hundred members, provides regular meal service and regu-
19 larly receives payment for dues, fees, use of space, facilities,
20 services, meals or beverages directly or indirectly from or on behalf of
21 a nonmember for the furtherance of trade or business. An institution,
22 club, or place of accommodation which is not deemed distinctly private
23 pursuant to this subdivision may nevertheless apply such selective
24 criteria as it chooses in the use of its facilities, in evaluating
25 applicants for membership and in the conduct of its activities, so long
26 as such selective criteria do not constitute discriminatory practices
27 under this article or any other provision of law. For the purposes of
28 this section, a corporation incorporated under the benevolent orders law
29 or described in the benevolent orders law but formed under any other law
30 of this state or a religious corporation incorporated under the educa-
31 tion law or the religious corporations law shall be deemed to be in its
32 nature distinctly private.
33 No institution, club, organization or place of accommodation which
34 sponsors or conducts any amateur athletic contest or sparring exhibition
35 and advertises or bills such contest or exhibition as a New York state
36 championship contest or uses the words "New York state" in its announce-
37 ments shall be deemed a private exhibition within the meaning of this
38 section.
39 43. The term "health care entity" means:
40 (a) a hospital or provider as defined by section twenty-eight hundred
41 one of the public health law; or
42 (b) a professional licensed under article one hundred thirty-one, one
43 hundred thirty-one-B, one hundred thirty-one-C, one hundred thirty-two,
44 one hundred thirty-three, one hundred thirty-four, one hundred thirty-
45 six, one hundred thirty-seven, one hundred thirty-seven-A, one hundred
46 thirty-nine, one hundred forty, one hundred forty-one, one hundred
47 forty-three, one hundred forty-four, one hundred fifty-three, one
48 hundred fifty-seven, one hundred sixty-three, one hundred sixty-four, or
49 one hundred sixty-seven of the education law; or
50 (c) an issuer or provider of coverage for health insurance, as defined
51 by section seven thousand seven hundred five of the insurance law.
52 § 3. The section heading and the opening paragraph and paragraphs 4, 7
53 and 8 of subsection (a) of section 3243 of the insurance law, as added
54 by section 2 of subpart D of part J of chapter 57 of the laws of 2019,
55 are amended and four new paragraphs 9, 10, 11 and 12 are added to
56 subsection (a) to read as follows:
S. 9275 3
1 Discrimination because of race, national origin, age, disability, sex
2 or marital status in hospital, surgical or medical expense insurance.
3 With regard to an accident and health insurance policy that provides
4 hospital, surgical, or medical expense coverage or a policy of student
5 accident and health insurance, as defined in subsection (a) of section
6 three thousand two hundred forty of this article, delivered or issued
7 for delivery in this state, no insurer shall because of race, color,
8 creed, national origin, sex, marital status, disability, preexisting
9 condition, or based on pregnancy, false pregnancy, termination of preg-
10 nancy, or recovery therefrom, childbirth or related medical conditions:
11 (4) insert in the policy any condition, or make any stipulation,
12 whereby the insured binds [his or herself] themselves, or [his or her]
13 such insured's heirs, executors, administrators or assigns, to accept
14 any sum or service less than the full value or amount of such policy in
15 case of a claim thereon except such conditions and stipulations as are
16 imposed upon others in similar cases; and any such stipulation or condi-
17 tion so made or inserted shall be void;
18 (7) fix any lower rate or discriminate in the fees or commissions of
19 insurance agents or insurance brokers for writing or renewing such a
20 policy; [or]
21 (8) engage in sexual stereotyping[.];
22 (9) include a policy clause that purports to deny, limit, or exclude
23 coverage based on an insured's sexual orientation, gender identity or
24 expression, or transgender status;
25 (10) deny, limit, or otherwise exclude medically necessary services or
26 treatment otherwise covered by a policy on the basis that the treatment
27 is for gender dysphoria or gender incongruence; provided further that an
28 insurer shall provide an insured with the utilization review appeal
29 rights required by insurance law and public health law articles forty-
30 nine for gender dysphoria or gender incongruence treatment that is
31 denied based on medical necessity;
32 (11) designate an insured's sexual orientation, gender identity or
33 expression, or transgender status as a pre-existing condition for the
34 purpose of denying, limiting, or excluding coverage; or
35 (12) deny a claim from an insured of one gender or sex for a service
36 that is typically or exclusively provided to an individual of another
37 gender or sex unless the insurer has taken reasonable steps, including
38 requesting additional information, to determine whether the insured is
39 eligible for the services prior to denial of such claim.
40 § 4. Section 4303 of the insurance law is amended by adding a new
41 subsection (yy) to read as follows:
42 (yy)(1) Every policy which provides hospital, surgical, or medical
43 coverage shall provide medically necessary services or treatment other-
44 wise covered by a policy on the basis that the treatment is for gender
45 dysphoria or gender incongruence.
46 (2) Coverage for gender dysphoria or gender incongruence shall not be
47 subject to annual deductibles or coinsurance, including co-payments,
48 unless the policy is a high deductible health plan as defined in section
49 223(c)(2) of the internal revenue code of 1986, in which case coverage
50 for gender dysphoria or gender incongruence may be subject to the plan's
51 annual deductible.
52 § 5. Subsection (k) of section 3221 of the insurance law is amended by
53 adding a new paragraph 24 to read as follows:
54 (24) (A) Every policy which provides hospital, surgical, or medical
55 coverage shall also provide coverage for medically necessary services or
S. 9275 4
1 treatments for gender dysphoria or gender incongruence that are other-
2 wise covered by the policy.
3 (B) Coverage for the treatment of gender dysphoria or gender incongru-
4 ence shall not be subject to annual deductibles or coinsurance, includ-
5 ing co-payments, unless the policy is a high deductible health plan as
6 defined in section 223(c)(2) of the internal revenue code of 1986, in
7 which case coverage for gender dysphoria or gender incongruence may be
8 subject to the plan's annual deductible.
9 § 6. Subsection (i) of section 3216 of the insurance law is amended by
10 adding a new paragraph 42 to read as follows:
11 (42)(A) Every policy which provides hospital, surgical, or medical
12 coverage shall also provide coverage for medically necessary services or
13 treatments for gender dysphoria or gender incongruence that are other-
14 wise covered by the policy.
15 (B) Coverage for gender dysphoria or gender incongruence shall not be
16 subject to annual deductibles or coinsurance, including co-payments,
17 unless the policy is a high deductible health plan as defined in section
18 223(c)(2) of the internal revenue code of 1986, in which case coverage
19 for gender dysphoria or gender incongruence may be subject to the plan's
20 annual deductible.
21 § 7. Severability. If any clause, sentence, paragraph, section or part
22 of this act shall be adjudged by any court of competent jurisdiction to
23 be invalid and after exhaustion of all further judicial review, the
24 judgment shall not affect, impair or invalidate the remainder thereof,
25 but shall be confined in its operation to the clause, sentence, para-
26 graph, section or part of this act directly involved in the controversy
27 in which the judgment shall have been rendered.
28 § 8. This act shall take effect immediately.
