RALEIGH (AP) — The health insurance plan for North Carolina government employees, teachers, retirees and their families next month will begin covering some sex change surgeries and hormone therapy, but the incoming state treasurer isn’t happy about the decision.

The State Health Plan’s trustee board voted this month to remove previous exclusions and cover the treatments when considered medically necessary.

A spokesman for current Treasurer Janet Cowell, whose office oversees the plan, told The News & Observer of Raleigh the plan risked losing millions of dollars if it didn’t comply with new federal regulations and offer the treatments. The plan also “faced discrimination lawsuits for non-compliance,” spokesman Brad Young wrote in an email. Plans in other states also are offering the coverage.

“We are pleased to see the plan be updated to match major employers and other governments around the country in providing critical care for trans-employees,” said Matt Hirschy, a spokesman for the gay rights group Equality North Carolina.

Cowell, a Democrat, didn’t seek re-election. She’ll be succeeded next month by Republican Dale Folwell, who says he’ll conduct an investigation to examine the true financial and legal implications of the decision, which only applies to 2017 benefits.

“I pledged to the people of North Carolina that we would reduce the state health plan’s $32 billion debt, provide a more affordable family premium especially for our lowest paid employees and provide transparency to the taxpayers,” Folwell said in an email. “The provision to pay for sex change operations does none of those three things.”

The additional coverage will cost the state from $350,000 to $850,000 annually, with from eight to 24 members under the plan using those benefits, the consulting firm The Segal Group told state officials. The plan covers more than 700,000 people.

Folwell said his investigation after he takes office will examine “the true legal and financial implications of this provision and report those findings to the citizens of (North Carolina) who will be paying for it.”

At the Dec. 2 meeting of the State Health Plan board, members learned about gender-related conditions, known as gender dysphoria, treatment and the risks of failing to comply with federal rules. Cowell broke a tie on a procedural vote by the board that would have tabled the motion to remove the exclusions to a future meeting, The News & Observer reported.