The Department of Health and Human Services issued a final regulation Friday that will pressure health insurers to cover sex change operations, which could then be subsidized by taxpayers through Medicare, Medicaid, and Obamacare.

The final rule comes the same day the Obama administration ordered schools to let children use whatever bathroom or locker room matches “their chosen gender identity,” or risk losing federal funding.

The agency released its final “Nondiscrimination in Health Programs and Activities” rule, which enforces Section 1557 of the Affordable Care Act.

The regulation “prohibits discrimination based on race, color, national origin, sex, age, or disability; enhances language assistance for individuals with limited English proficiency; and protects individuals with disabilities,” the agency said in a release.

Doctors and health insurers also cannot deny “health care or health coverage based on an individual’s sex, including discrimination based on pregnancy, gender identity, and sex stereotyping.”

In a fact sheet on the portion of the rule regarding sex discrimination, the government explains that health care providers cannot refuse to cover all services related to a sex change—such as hormone therapy, breast implants, and the surgery itself—as a matter of policy.

“Categorical coverage exclusions or limitations for all health care services related to gender transition are discriminatory,” the agency said.

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