A federal court on Monday blocked West Virginia and North Carolina laws that prevent state health-insurance plans from covering gender-transition procedures.
The federal appeals court ruled 8-6 that North Carolina’s state employee health program and West Virginia’s Medicaid program, both of which do not cover hormone treatments and gender-transition surgeries, are discriminatory.
“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, a George W. Bush appointee, wrote in the majority opinion.
Earlier this month, the 4th Circuit judges overturned a West Virginia law that prohibits male athletes from competing in women’s sports. The court argued that the legislation infringed upon the Title IX right of plaintiff student Becky Pepper-Jackson — a pre-teen boy interested in trying out for his middle-school girls’ cross-country team — to compete in the women’s category. Title IX is the federal law barring discrimination on the basis of sex, and now gender identity under the Biden administration’s latest radical revision, in federally funded educational institutions.
A week before the 4th Circuit decision, the Supreme Court refused to reinstate the West Virginia law banning men and boys who “identify” as female from participating in women’s and girls’ sports. West Virginia attorney general Patrick Morrisey first pledged to appeal both the sports ruling and, on Wednesday, the court’s transgender medicine 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.
Filed by LGBT organization Lambda Legal and legal partners, the case claimed the state violated federal anti-discrimination law by denying coverage for sex-change procedures for gender dysphoric patients. Shauntae Anderson, a Black transgender-identifying man and West Virginia Medicaid participant, joined the lawsuit as a plaintiff in late 2021.
“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 obtained by the Associated Press.
At the federal level, Congress in summer 2023 advanced an appropriations bill providing for military housing and medical care onto which the GOP had included restrictions on gender medicalization and abortion. The House passed the measure, which included an amendment from Representative Matt Rosendale that barred military health insurance and the Department of Defense from providing or covering gender transition surgery and hormone therapy. Those gender limitations were later scrapped in a later-negotiated version that was delivered to President Biden to sign.