A Nevada bill is seeking to secure gender-affirming health care for transgender and gender non-conforming individuals in the state.

SB 163 would require health insurance companies to provide coverage for treatments and procedures relating to gender dysphoria and gender incongruence.

Amy Koo - acting deputy director of ONE APIA Nevada - said health care in the U.S. is "convoluted" as is, but adds SB 163 would help recognize and streamline gender-affirming health care for folks in Nevada, setting what she calls a model for the rest of the country.

Koo said it is important to note a bill like this doesn't necessarily make it easier to access gender-affirming care, but aims to remove outside barriers.

"This bill is going to be helping those of us who are most vulnerable to the tides of discrimination," said Koo, "and so that is something I really want to highlight - that this doesn't make it easier for people to access the care, it just makes sure other outside factors aren't able to prevent people from accessing that care."

Koo said while many states around the country move to restrict or ban gender-affirming health care, she said she is pleased to see Nevada pushing to make health care more equitable for a population she says is high risk.

Preston Tang, an advisor with the Southern Nevada Asian Pacific Islander Queer Society, said they're always receiving calls from individuals trying to find providers and insurance plans that cover gender-affirming care.

He said the situation is "frustrating" but is happy to know SB 163 could change that.

Tang said there is growing consensus among experts and medical professionals that recognize the importance of gender-affirming health care. He said while advocating may seem intimidating, now is the time for action because many LGBTQ causes and rights are under attack.

"This is the time where we need to rally together, as human beings, as allies," said Tang, "to support our LGBT community and or transgender siblings so that we can ensure that they have equal access to medical care."

Senate Bill 163 is being sponsored by Sens. Melanie Scheible and Dallas Harris, both D-Las Vegas. The bill would require public and private health-care plans, including Medicaid, to cover medical services but would also establish requirements before the insurer will cover certain gender-affirming procedures.




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Advocacy groups are speaking out about how they believe congressional cuts to Medicaid will disproportionately affect caregiver LGBTQ+ communities in Illinois.

Jaimie Worker, senior director of policy and research for the advocacy group Caring Across Generations, said Medicaid can be a lifeline for LGBTQ+ people who are aging or living with disabilities, especially those without traditional family support. She explained for many, care is provided by "chosen family" or friends, with support from Medicaid largely making that possible.

"LGBTQ+ communities are impacted in a unique way when it comes to self-directed care: being able to choose who your care provider is as an older adult or person with a disability," Worker pointed out. "Many of these programs are heavily supported by Medicaid."

She noted as people already face barriers to receiving the care they need, Medicaid cuts would unnecessarily force some into institutional settings like nursing homes, where they would never have chosen to receive care.

An estimated 700,000 people nationwide are on waiting lists to receive home- and community-based care through Medicaid. Last year, more than 15,000 were in Illinois. No matter how dire their need, Worker stressed people can wait years to access these services and LGBTQ+ individuals face additional barriers.

"Those are the folks who already know about the services; not everyone is aware about the services that are available. LGBTQ folks are also more likely to experience discrimination while trying to access care needs."

Currently, people who make less than $22,000 a year in Illinois could qualify for Medicaid. Worker predicts new federal qualifications will make it more difficult for people to qualify, even with extremely limited resources.

"And make it harder for people to live and age with dignity, and largely in their own homes and communities where most people would prefer to live and age," Worker underscored.

She reported starting July 24, Caring Across Generations will host a 60-hour vigil for Medicaid in Washington, D.C., to amplify the stories of caregivers, people with disabilities, older adults and families from across the country.

This week, the law guaranteeing same-sex marriage equality turned 10. But advocates are concerned about the growing number of threats it now faces.

A decade after the Supreme Court's historic Obergefell v. Hodges decision, most Americans are onboard with gay marriage. While President Donald Trump has never stated outright opposition, members of his conservative base do. And with a conservative Supreme Court majority, Justices Samuel Alito and Clarence Thomas have also signaled they'd like to revisit the issue.

Despite pressure from the far right, said Jenny Pizer, chief legal officer at Lambda Legal, ending same-sex marriage isn't something that has public support.

"I think what is key for people to have in mind is, there's no case in front of the Supreme Court pending for a court review at this moment," she said, "and the Supreme Court can't review a case and consider a case without there being a case -- and there is none at this point."

She reminded folks that Congress passed the Respect for Marriage Act in 2022, which codified marriage protections for same-sex and interracial couples. It also repealed the Defense of Marriage Act, a 1996 law that exclusively recognized marriage between one man and one woman.

In 2020, Nevada became the first state to enshrine gay couples' right to marry in its state Constitution.

Even if the law were overturned and certain states were what she called "hostile" to same-sex couples who want to marry, Pizer said, states would have to continue to respect and honor same-sex marriages. She added that folks should not be panicking, but should be paying attention.

"The bottom line is that we have to keep our eye on this," she said. "We know that there are those on the far right who want to raise money on this issue, want to gin up fears on this issue, use it for organizing."

Since the Supreme Court's decision in June 2015, almost 600,000 same-sex couples have married legally. In the United States alone, there are about 823,000 married gay couples, according to the Williams Institute at the UCLA School of Law.

June is Pride Month, and people who fight for LGBTQ+ health care are speaking out against huge proposed cuts to Medicaid, known as Medi-Cal in the Golden State.

The U.S. Senate is about to vote on the reconciliation bill, known as the "One Big Beautiful Bill Act." Republican backers say they want to add more work requirements and make people reapply every six months.

Juan Carlos Guerrero, western regional organizing manager for the nonprofit Caring Across Generations, said that will kick eligible people off the program.

"This is part of a misinformation that we're trying to really address and make clear that these are cuts to Medicaid services that are going to be felt in the community around us," he said, "through people who use it for in-hospital services, people who use it for in-home supportive services."

The bill's supporters have said they want to use the Medicaid savings to fund an extension of President Donald Trump's 2017 tax cuts.

LGBTQ+ people are three to four times less likely to have children and twice as likely to be single and living alone as adults, so they often depend on Medicaid. Caring Across Generations is organizing a 60-hour vigil for Medicaid on the U.S. Capitol grounds July 24-26. By that time, Guerrero said, the Senate and House will have each passed their own version of the bill and will need to hash out a compromise.

"There will have to be a larger discussion between them to reach a strong consensus on what the cuts should include," he said, "but with both their packages being different enough where it will lead to larger-scale conversations."

The mobilization protests in July will also highlight some important anniversaries coming up. July 28 is the anniversary of the Americans with Disabilities Act, July 30 marks Medicaid's 60th birthday, and in mid-August, the Social Security Act will turn 80 years old.