Section 1557 for Self-funded plans.
Under Section 1557 of the Affordable Care Act (ACA), health facilities, programs, and activities receiving federal funding may not deny insurance coverage or care on the basis of, among other things, sex and gender identity and expression.
I remember reading somewhere that Section 1557 also applied to contractors and subcontractors for groups receiving federal funding. My question is this: if I work for a housekeeping company that is contracted to a hospital, is my company's self-insured insurance plan allowed to categorically deny all gender-affirming healthcare under ERISA? Or does our nature as a contractor for an organization that receives Federal funding mean that we cannot exclude such coverage?
If it makes any difference, I live in a state (Virginia) that already has laws against such exclusions, but the plan being self-funded has skirted that law under ERISA so far.
As a related question, is there any way to qualify for the APTC on a Marketplace plan if my work offers insurance that does not cover medically neccesary care? My work-provided insurance does not cover what I need, but I fear that it's availability might disqualify me from affordable Marketplace alternatives.
submitted by /u/SoftBoiledEgg_irl
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