Judges say WV, NC transgender care cover policies discriminate
CHARLESTON, W.Va. (AP) — West Virginia and North Carolina's refusal to cover certain health care for transgender people with government-sponsored insurance is discriminatory, a federal appeals court ruled Monday in a case likely headed to the U.S. Supreme Court.
The Richmond-based 4th U.S. Circuit Court of Appeals ruled 8-6 in the case involving coverage of gender-affirming care by North Carolina's state employee health plan and the coverage of genderaffirming surgery by West Virginia Medicaid.
"The coverage exclusions facially discriminate on the basis of sex and gender identity, and are not substantially related to an important government interest," Judge Roger Gregory, first appointed by former President Bill Clinton and re-appointed by former President George W. Bush, wrote in the majority opinion.
The ruling follows a decision earlier this month by 4th Circuit judges that West Virginia's transgender sports ban violates the rights of a teen athlete under Title IX, the federal civil rights law that prohibits sex-based discrimination in schools.
Like with the transgender sports law ruling, West Virginia Attorney General Patrick Morrisey said his office planned to appeal Wednesday's health care case decision.
"Decisions like this one, from a court dominated by Obama- and Biden-appointees, cannot stand: we'll take this up to the Supreme Court and win," Morrisey said in a statement.
After the ruling, West Virginia plaintiff Shauntae Anderson, a Black transgender woman and West Virginia Medicaid participant, called her state's refusal to cover her care "deeply dehumanizing."
"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," Anderson said in a statement.
A spokesperson for North Carolina State Treasurer Dale Folwell, whose department oversees the state's health plan, said the agency was still reviewing the decision Monday but would have a response later.
During oral arguments in September, at least two judges said it's likely the case will eventually reach the U.S. Supreme Court. Both states appealed separate lower court rulings that found the denial of genderaffirming care to be discriminatory and unconstitutional.