CHARLESTON, W.Va. – West Virginia and North Carolina’s refusal to cover certain health services for transgender people with their government-sponsored insurance is discriminatory, a federal appeals court ruled Monday in a case likely to be sent to the U.S. Supreme Court.
The Richmond-based 4th U.S. Circuit Court of Appeals ruled 8-6 in a case involving coverage of sex-affirming care by a North Carolina employee health plan and coverage of sex-affirming surgery by West Virginia Medicaid.
After the ruling, West Virginia plaintiff Shauntae Anderson, a black transgender woman and West Virginia Medicaid participant, called her state’s refusal to care for her “deeply dehumanizing.”
“I am so relieved that this court decision brings us one step closer to the day when Medicaid can no longer deny transgender West Virginians access to the essential health care that our doctors tell us we need,” Anderson said.
West Virginia Attorney General Patrick Morrisey immediately released a statement announcing his office’s intention to appeal.
“Court rulings like this, dominated by Obama and Biden appointees, cannot stand: we will take this to the Supreme Court and we will win,” Morrisey said.
During oral arguments in September, at least two justices said the case would reach the U.S. Supreme Court. Both states appealed separate lower court rulings that found denying gender-affirming care discriminatory and unconstitutional. Two panels of three Fourth Circuit judges heard arguments in both cases last year before deciding to consolidate the two cases and see them presented before the full 15-member court.
In June 2022, A Court of North Carolina required the state plan to pay for “medically necessary services” for transgender workers and their children, including hormone therapy and some surgeries. A judge ruled in favor of the employees and their dependents, who said in a 2019 lawsuit that they were not covered by the plan’s gender-affirming care.
North Carolina’s state insurance plan provides health insurance for more than 750,000 teachers, state employees, retirees, legislators and their dependents. While it offers counseling for gender dysphoria and other diagnosed mental health conditions, it does not cover treatment “in relation to gender changes or modifications and related care”.
In August 2022, a federal judge ruled that West Virginia’s Medicaid program provides coverage for gender-affirming care for transgender residents.
Moment original claim He also named the state employee health plans introduced in 2020. In 2022, a settlement with Health Plan of West Virginia Inc. led to the removal of an exclusion for gender-affirming care in that company’s Public Employees Insurance Agency plans.