Last year, a federal court in Washington State ruled that Premera Blue Cross unlawfully discriminated when it refused to cover elective double mastectomies for two young girls. The decision read like a harsh warning to every employer: exclude gender-transition procedures for children from your health plan and risk an Affordable Care Act discrimination claim. But the story doesn’t end there.
In July 2026, the United States filed a brief urging the Ninth Circuit to reject that court’s misguided reasoning.
