Gender Affirming Care — Coming to Your State Soon?

The issue involves the state healthcare plans of North Carolina and West Virginia. The 4th U.S. Circuit Court of Appeals upheld two lower court rulings and has ruled 8 to 6 that the two states have to roll back policies that exclude coverage for gender-affirming care.

In North Carolina the state’s plan doesn’t include coverage for “sex changes or modifications and related care.” West Virginia’s Medicaid plan just covers “some” gender-affirming treatments.

While both states argued that the policies are based on the cost of care and not judgements against transgender people, the majority of the judges disagreed. Judge Roger Gregory — who wrote the majority opinion — argued the restrictions from both states are quite obviously discriminatory.

“Because we hold that the coverage exclusions facially discriminate on the basis of sex and gender identity, and are not substantially related to an important government interest, we affirm the district courts,” Gregory wrote. “We further hold that the West Virginia exclusion violates the Medicaid Act and the Affordable Care Act.”

The judge agreed with plaintiff Shauntae Anderson who said the denial of coverage was a judgement about lifestyle and not cost.

“West Virginia’s denial of medically necessary care just because of who I am was deeply dehumanizing,” Anderson said. “I am so relieved that this court ruling puts us one step closer to the day when Medicaid can no longer deny transgender West Virginians access to the essential healthcare that our doctors say is necessary for us.”

Tara Borelli was the lead attorney for both cases. She said the lower courts and the U.S. district court made the right decision.

“It confirms that discriminating against transgender people by denying critical medical care is not only wrong but unconstitutional,” she said. “No one should be denied essential health care, but our clients in both cases were denied coverage for medically necessary care prescribed by their doctors just because they’re transgender.”

Gender-affirming care is excluded from state employee benefit plans in over a dozen states. Medical treatments for transgender youths has been banned in 24 of them. Medicaid policies in 10 states will not cover transition-related care.

Obviously disagreeing with the decision, West Virginia’s Republican attorney general, Patrick Morrisey said he will take the case to the U.S. Supreme Court.

Source link: The Hill —

About PIA Western Alliance

The Professional Insurance Agents Western Alliance is a membership organization promoting and enhancing the success of independent agencies seeking to grow, learn and be heard within the industry.


More Industry News