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Federal Appeals Court Takes Up Transgender Health Coverage Case From North Carolina

Source: ABC News

The Fourth Circuit Court of Appeals, based in Richmond, heard oral arguments earlier this month in two cases involving the coverage of gender-affirming care by state health plans, one in North Carolina and one in West Virginia.

The case could have significant implications on whether states are required to cover health care for transgender people on government-sponsored insurance. And it will likely be headed eventually to the U.S. Supreme Court, according to at least two judges on the Fourth Circuit.

The North Carolina state insurance plan provides medical coverage for more than 750,000 teachers, state employees, retirees, lawmakers, and their dependents. It does not cover transition-related care, so in 2019 a lawsuit was filed on behalf of several current and former state employees and their dependents. It alleged that the denial of coverage for gender-affirming care under the plan was discriminatory.

In 2022, a judge agreed and demanded the state plan pay for “medically necessary services,” including hormone therapy and some surgeries. That ruling is now being challenged in the Fourth Circuit Court.

Tara Borelli, a Senior Attorney at Lambda Legal who is representing the transgender people denied services in both states, decried the latest proceedings. “It is disappointing that state officials in North Carolina and West Virginia have chosen to double-down on the discriminatory denial of medically necessary, evidence-based care,” she said.

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