On December 23, Illinois joined 19 other states and the District of Columbia to explicitly require Medicaid to pay for transgender surgeries. The Department of Healthcare and Family Services, the state's primary Medicaid agency, published new administrative rules mandating the coverage of certain "gender-affirming" services. Illinois formerly excluded "transsexual surgery" from the taxpayer-funded program.

"Health care is a right, not a privilege, and I'm committed to ensuring our LGBTQ community and all Illinoisans have access to that right," Gov. J.B. Pritzker (D-Ill.) said in a statement in April.

"Expanding Medicaid to cover gender affirming surgeries is cost effective, helps avoid long-term health consequences, and most importantly is the right thing to do. With continued attacks coming from Washington, this administration will always stand with our transgender community and their right to lead safe and healthy lives."