Randall leads 43 Democrats in Demanding Answers from OPM Over Decision to Eliminate Coverage for Medically Necessary Trans Health Care

WASHINGTON, D.C. - Today, Congresswoman Emily Randall (D, WA-06), co-chair of the Congressional Equality Caucus, led a letteralongside 43 Democratic members to the Office of Personal Management (OPM) strongly opposing the agency's decision to eliminate coverage for medically necessary care for transgender individuals under the Federal Employee Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) for plans beginning in 2026.

This decision to eliminate coverage of this care, regardless of age, was made by OPM via a carrier letter in August 2025 and members of Congress have heard from federal employees who were unaware of this change until after enrollment. This change has resulted in federal employees no longer having access to FEHB and PSHB health insurance plans that cover the medically necessary care they or their family members need. This sudden exclusion of such care has likely resulted in interrupted treatment, forced discontinuation of prescribed medications, increased mental health crises, and significant financial hardship for affected individuals and families. In the letter, the members also demand detailed information regarding the process and impacts of OPM's decision to eliminate coverage.

"By categorically eliminating coverage for certain medical care, such as puberty-delaying medication and hormone therapy, for transgender people but allowing them for non-transgender people, this categorical exclusion violates Title VII's prohibition on sex discrimination in employer-provided healthcare plans," the members wrote. "Not only was this act unlawful, it was implemented without sufficient transparency to ensure that federal employees could make informed decisions during open enrollment.

The members continued: "OPM made the announcement in August 2025, and the change took effect for the 2026 plan year, covering selections made during the 2026 Open Season from November 10 to December 8, 2025. During the 2026 open enrollment period, many employees may not have fully understood how the change would affect their prescribed or ongoing care until after enrollment closed. This is unfair and unacceptable."

In the letter, the members point out that eliminating care by categorically excluding coverage for medically necessary care for transgender people is a clear violation of Title VII of the Civil Rights Act. Title VII prohibits employers, including the federal government, from discriminating in employment-including in "compensation, terms, conditions, or privileges of employment"-on the basis of sex, among other protected characteristics.

The members also request that OPM provide written responses to the following questions by March 18, 2026.

1. Before issuing carrier letters 2025-01a and 2025-01b, did OPM conduct or rely on any legal analyses regarding its authority to categorically exclude coverage for gender-affirming care and its obligations under federal civil rights laws, including Title VII of the Civil Rights Act Please provide all relevant legal analyses conducted or relied on by OPM.
2. How was the decision to eliminate this coverage developed and implemented within OPM, including the timing of the decision, the offices or officials involved, and any alternative approaches that were considered? Please provide all relevant documents and communications related to this decision making, including all documents and communications relating to the decision to expand the categorical exclusion in carrier letter 2025-01a to include adults (as memorialized in carrier letter 2025-01b)
3. What steps did OPM take to notify FEHB and PSHB enrollees of this coverage change prior to and during the 2026 open enrollment period, and how did OPM determine that this notice was adequate?
4. Did OPM make any attempts to calculate how many FEHB and PSHB enrollees would be affected by the elimination of this coverage? If yes, please provide all relevant documents and the results.
5. Did OPM conduct any assessments of the medical, workforce, or civil rights impacts of this policy prior to implementation, and if so, what were the findings?
6. How does OPM reconcile the exclusion of gender-affirming care with federal nondiscrimination obligations, particularly given that FEHB and PSHB plans continue to cover comparable hormone therapies for other medical diagnoses?; and
7. How is OPM ensuring that covered plans include the exception process described in Carrier Letter Number 2025-01b?

Congresswoman Randall (D, WA-06) was joined by Congressional Equality Caucus Chair, Rep. Mark Takano (D, CA-39), and Representatives Robert Garcia (D, CA-42), Sarah McBride (D, DE-AL), Raja Krishnamoorthi (D, IL-08), Mark Pocan (D, WI-02), Becca Balint (D, VT-AL), Angie Craig (D, MN-02), Pramila Jayapal (D, WA-07), Sara Jacobs (D, CA-51), Eric Sorensen (D, IL-17), Delia C. Ramirez (D, IL-03), Eleanor Holmes Norton (D, DC-AL), Paul Tonko (D, NY-20), Lateefah Simon (D, CA-12), Dan Goldman (D, NY-10), Rashida Tlaib (D, MI-12), Deborah K. Ross (D, NC-02), Jerrold Nadler (D, NY-12), Stephen F. Lynch (D, MA-08), Shri Thanedar (D,MI-13), Andrea Salinas (D, OR-06), Suzan K. DelBene (D, WA-01), Dave Min (D, CA-47), Summer L. Lee (D, PA-12), James R. Walkinshaw (D, VA-11), Laura Friedman (D, CA-30), Sylvia R. Garcia (D, TX-29), Frederica S. Wilson (D, FL-24), Steve Cohen (D, TN-09), Judy Chu (D, CA-28), Suzanne Bonamici (D, OR-01), Jan Schakowsky (D, IL-09), LaMonica McIver (D, NJ-10), Kevin Mullin (D, CA-15), Sam T. Liccardo (D, CA-16), Betty McCollum (D, MN-04), James P. McGovern (D, MA-02), Ayanna Pressley (D, MA-07), Jahana Hayes (D, CT-05), Gilbert Ray Cisneros, Jr. (D, CA-31), Donald S. Beyer Jr. (D, VA-08), Mark DeSaulnier (D, CA-10) and Luz M. Rivas (D, CA-29) in sending the letter.

The full text of the letter is available HERE.

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