Federal Court Mandates Coverage of Transgender Care by State Health Plans

A recent ruling by a federal appeals court in Virginia has decreed that state healthcare plans must cover transgender care.

The decision comes after disputes in West Virginia and North Carolina where they refused to provide certain healthcare services for transgender individuals under government insurance.

The judgment from the Richmond-based 4th U.S. Circuit Court of Appeals, passed with an 8-6 majority, deemed the states’ actions as discriminatory.

West Virginia Attorney General Patrick Morrisey has announced plans to appeal, stating, “Decisions from a court filled with Obama- and Biden-appointees will not be accepted; we will take this to the Supreme Court and win.”

After the ruling, West Virginia plaintiff Shauntae Anderson, a Black transgender woman and Medicaid participant, expressed relief that the court decision brings them one step closer to accessing essential healthcare.

“I am relieved by this court ruling that brings Medicaid one step closer to providing necessary healthcare for transgender West Virginians,” Anderson stated.

During September’s hearings, judges indicated the case may eventually reach the U.S. Supreme Court.

Both states had appealed lower court decisions deeming the denial of gender care as discriminatory and unconstitutional. Two panel hearings from the Fourth Circuit decided to consolidate the cases for a full court review.

In June 2022, a North Carolina court ruled that the state plan should cover medically necessary services, like hormone therapy and surgeries, for transgender employees and their dependents. The ruling favored employees who were denied coverage for gender-related healthcare under the plan.

The North Carolina state insurance plan covers over 750,000 individuals but does not include treatment for sex changes or modifications, even though it provides counseling for gender dysphoria and other mental health conditions.

In August 2022, a federal judge mandated that West Virginia’s Medicaid program must include coverage for transgender care.

An initial lawsuit filed in 2020 targeted state employee health plans, and a settlement in 2022 with The Health Plan of West Virginia Inc. led to the removal of exclusions on gender-related healthcare.

Newsmax staff and The Associated Press contributed to this report.