"The latest dispute over the health care law may have to be resolved by the courts. The law's nondiscrimination section applies federal civil rights protections to programs under the health overhaul. The legal text refers to entities 'receiving federal financial assistance,' interpreted to include insurers, state Medicaid agencies, hospitals and other service providers. It doesn't mention major private employers that run their own health plans. A group representing big employers said its members don't have particular qualms about gender transition. But large employers do object to what they see as an overreach by the Obama administration, since their health plans don't get federal financial assistance."