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Health plans must pay for all types of preventive care, including a pill to prevent H.I.V., while an appeals court deliberates whether to strike down part of the Affordable Care Act.
Missouri has imposed sweeping rules to limit health care for trans adults. Other states have banned Medicaid coverage or introduced bills outlawing care for young adults.
The state awarded a $50 million contract to produce less costly treatments, but moves by major suppliers might undercut the initiative before any new product emerges.