On January 22, 2024, the U.S. District Court for the Western District of Washington entered a judgment for a class of transgender insureds against Blue Cross Blue Shield of Illinois. The district court ordered that the class is entitled to declaratory relief, and that Blue Cross’s administration and enforcement of categorical exclusions of gender affirming medical care constituted discrimination on the basis of sex in violation of Section 1557 of the Affordable Care Act. The district court also permanently enjoined Blue Cross from administering or enforcing such exclusions going forward. On Blue Cross’s motion, the district court has stayed enforcement of the order pending Blue Cross’s appeal in the Ninth Circuit. No. 23-4331, see also Pritchard et al. v. Blue Cross Blue Shield of Illinois, Case No. 3:20-cv-06145, W.D. Wash.