A federal court in Georgia ruled Thursday that employers who flatly exclude sex-assertion Medicare from health insurance coverage are in violation of federal law.
Anna Lange, a transgender woman and deputy mayor of Houston, Georgia, filed a lawsuit in 2019 after being denied coverage for a vaginoplasty in November 2018.
The sheriff’s office provides health care coverage to employees through the county plan, which, beginning in 1998, has excluded coverage for gender-associated speech therapy, sex-confirmation hormone therapy, and gender-confirmation surgeries, according to the opinion issued Thursday.
Chief Justice of the U.S. District Court for the Central District of Georgia, Mark Treadwell, wrote in the opinion that the exclusion “clearly discriminates by reason of transgender status,” and as a result would violate Title VII of the Civil Rights Act of 1964, a federal law prohibiting employment discrimination on the basis of race. gender, religion, national origin and other protected categories.
He cited evidence that the Houston County Health Care Plan, offered through Anthem Blue Cross and Blue Shield, would provide menopausal hormone therapy and surgery for breast cancer, but would not offer the same procedures as treating gender dysphoria.
“The undisputed end point is that exclusion only applies to transgender members, and applies to Lange because she is transgender,” Treadwell wrote, citing Historic decision of the Supreme Court In June 2020, which found that Article VII’s protection against discrimination on the basis of sex also includes discrimination of gender identity and sexual orientation.
The opinion also noted that in 2016, the Houston County insurance broker, which acted as a liaison between the county and Anthem, told the county that Anthem was no longer categorically excluding coverage of sexual dysphoria treatments as a result of the Affordable Care Act. Section 1557 prohibits discrimination on the basis of sex and other characteristics.
According to the opinion, “despite Anthem’s recommendation to do so, the county has chosen not to accept the nondiscrimination mandate.”
A representative for Houston County did not immediately respond to a request for comment.
“It is a great relief to know that I can finally receive necessary medical care that has been repeatedly and unfairly denied,” Lange, who was represented in part by the Transgender Legal Defense and Education Fund, said in a statement.
“I can confidently move forward with my life knowing that gender affirmation care is protected by federal law,” she said. “This decision is not only a personal victory, but a huge step forward for all transgender Southerners seeking insurance coverage for their needed care.” “
David Brown, legal director of the Transgender Legal Defense and Education Trust, said the court’s decision “demonstrates that denying transgender people access to health care is not only immoral but also illegal.”
He said, “An employer cannot deny health coverage to a transgender employee who needs to obtain essential life-saving medical care. This ruling will have a transformative impact on the quality of life of the countless transgender people living in the South.”
a Report Last year from the Center for American Progress, a liberal think tank, found that Many transgender people have reported facing security barriers takes care. Forty percent of transgender respondents — and 56 percent of respondents of color — said their health insurance companies declined coverage of gender confirmation care, which includes treatments such as hormones and surgery. The report also found that 48 percent of transgender respondents, including 54 percent of black respondents, said their health insurance companies only cover some gender confirmation care or have no providers in the network.
State laws regulating relocation-related care coverage vary widely. Twenty-four states and Washington, D.C., Banning the exclusion of transgender people in health insurance coverage, according to the Movement Progress Project, a non-profit think tank. Twenty-four states, one district and Washington, D.C., have Medicaid policies Explicitly covering transitional care for transgender people.
The remaining states have a mix of policies: some have no Medicaid policy that explicitly covers transgender care, 10 have Medicaid policies that explicitly exclude Medicaid coverage and Medicare, and one state—Arkansas—allows all state insurers to refuse coverage for affirmative-gender care .
In the past year, some Republican state leaders have attempted to restrict access to gender-emphasizing medical care in other ways. For example, the governors of Arkansas, Tennessee, and Alabama signed measures banning access to certain relocation-related care, Florida Governor Ron DeSantis administered Thursday. I moved to restrict care to minors and for trans people of all ages on Medicaid.
But an increasing number of courts have ruled in favor of transgender people who have sued for coverage. In September, the Fourth Circuit of the US Court of Appeals I ruled it Transgender people enrolled in the North Carolina health plan can file a lawsuit against the state’s 2018 policy that excludes all coverage of gender dysphoria counseling, hormone therapy, surgical care, and other treatments.
Then in November, A judge ruled in Iowa A law prohibiting Medicaid from covering gender-affirming surgeries violates state law and the state constitution.
Some health insurance companies have also updated their policies over the years. For example, Blue Cross and Blue Shield of North Carolina changed their policies last July to include sex-confirmation facial surgery and voice therapy as essential medical care.