Monday, April 29, 2024

Federal court rules that state healthcare plans can't deny gender-affirming care to trans individuals

A wonderful bit of news just came from the courts on Monday for the transgender community.

From MetroWeekly:

A federal appeals court ruled that states can’t deny insurance coverage for gender-affirming medical care to transgender individuals. The full panel of the 4th U.S. Circuit Court of Appeals ruled in favor of transgender plaintiffs in two cases from North Carolina and West Virginia, finding that existing insurance exclusions on gender-affirming care are discriminatory and unconstitutional. 

 Lawyers for the plaintiffs noted that this most recent ruling sets precedent, not only for North Carolina and West Virginia, but all other states within the 4th Circuit, including South Carolina, where state officials are considering a ban on gender-affirming care for minors — one of the few Southern states without a ban currently in place. 

 “The court’s decision sends a clear message that gender-affirming care is critical medical care for transgender people and that denying it is harmful and unlawful,” Omar Gonzalez-Pagan, counsel and health care strategist for Lambda Legal, said in a statement. The plaintiffs celebrated the appeals court’s ruling as a victory for transgender people.

 . . .In 2020, Lambda Legal, together with employment attorney firm Nichols Kaster, PLLP, and The Employment Law Center, PLLC, filed a lawsuit against West Virginia officials on behalf of a Medicaid participant, Christopher Fain, who was denied coverage for gender confirmation surgery. That same lawsuit also previously challenged a similar exclusion contained in West Virginia’s state employee health insurance plan on behalf of two state employees who could not obtain coverage for gender-affirming treatments, either for themselves or their dependents.

Lambda Legal subsequently added additional transgender plaintiffs to the case, including Shauntae Anderson. The state employee plaintiffs’ claims were eventually resolved by a 2022 settlement with The Health Plan of West Virginia, Inc., which removed its exclusion on gender-affirming care. The lawsuit subsequently resumed, challenging only the Medicaid exclusion.