Dem-dominated federal court rules state healthcare plans must include ‘gender-affirming care’ coverage

A Democrat-dominated federal appellate court ruled Monday that state healthcare plans must pay for transgender surgery.

The ruling by the U.S. Court of Appeals for the 4th Circuit pertained to a set of cases from North Carolina and West Virginia, where officials have reportedly argued against paying for transgender surgeries due to cost concerns.

“One [case] was brought by North Carolina state employees and their dependents who are transgender and were unable to get coverage for gender-affirming care,” according to NPR.

“The other lawsuit came from West Virginians who are transgender and on Medicaid. They could get coverage for some treatments — like hormones — but not for surgery,” NPR notes.

The court’s eight Democrat justices rejected state officials’ argument on the basis that denying transgender surgeries would be discriminatory to transgender people.

“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 wrote in the majority opinion.

The court’s Republican justices disagreed.

“Today’s result is a victory for plaintiffs but a defeat for the rule of law,” they wrote in their own dissenting opinion. “To reach its holding, the majority misconstrues the challenged policies and steamrolls over the careful distinctions embedded in Equal Protection doctrine.”

“It finds unlawful discrimination where there is none, stripping the states of their prerogative to create health-insurance and Medicaid systems that serve the best interests of their overall populations,” their opinion continued.

The case is now expected to move to the Supreme Court.

“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,” West Virginia Attorney General Patrick Morrisey said in a statement.

“We are confident in the merits of our case: that this is a flawed decision and states have wide discretion to determine what procedures their programs can cover based on cost and other concerns. Just one single sex-transition surgery can cost tens of thousands of dollars—taxpayers should not be required to pay for these surgeries under Medicaid. Our state should have the ability to determine how to spend our resources to care for the vital medical needs of our citizens,” he added.

North Carolina State Treasurer Dale Folwell meanwhile doubled down on the cost argument, making the case in a statement that the state’s “Plan” faces insolvency if transgender surgery is included.

“It is our mission to protect the Plan for our more than 750,000 current members, as well as future members,” he said. “Key to achieving this mission is protecting the Plan’s fiscal sustainability; simply, the Plan must continue to exist for our current and future members.”

“However, due to unabated and rapidly increasing health care costs, funding that has not increased at the same rate, and the aging and declining health of the Plan member pool (due in part to the inability to attract younger dependents and families into the SHP because of high family premiums), the Plan is facing the real risk of looming insolvency. Accordingly, the Plan cannot be everything for everyone — our priority is to provide coverage that does the most good for the highest number of people with the finite resources we have available,” he added.

The plaintiffs meanwhile were thrilled.

“We’re absolutely thrilled that the court ruled that discriminatory treatment just has no place under the law,” Tara Borelli of Lambda Legal, told NPR.

Critics on social media meanwhile sided with West Virginia and North Carolina for a variety of reasons.

Look (*Language warning):

Vivek Saxena


We have no tolerance for comments containing violence, racism, profanity, vulgarity, doxing, or discourteous behavior. If a comment is spam, instead of replying to it please click the ∨ icon below and to the right of that comment. Thank you for partnering with us to maintain fruitful conversation.

Latest Articles