Colorado state officials announced last week that health insurance plans will be required to cover gender-confirmation care for transgender people, starting in 2023. The federal government has approved the change, calling it a “landmark step” in addressing health care disparities.

Colorado’s policy change means that many private health care plans will be required to cover hormone therapy, gender confirmation surgery, and facial surgery for transgender patients. Procedures that Rodrigo Heng-Lehtinen with the National Center for Transgender Equality said “are actually recognized as primary care … this is essential health care and it deserves to be covered.”

Colorado is the first state to mandate this level of care, said Lindsey Dawson with the Kaiser Family Foundation. 

“But other states can certainly follow suit,” she said.

For trans folks in Colorado, it now means they don’t have to pay out of pocket for care that can cost tens of thousands of dollars. Marvyn Allen, with One Colorado, an LGBTQ advocacy organization in Denver, remembers that stress. Before getting surgery years ago, Allen spent a lot of time evaluating their finances, “and try to figure out, how the heck am I going to pay for this?”

And, Allen said, once people get the care they need, they can move on with their lives and focus on other things.