Personal care treatments

NC health plan must cover transgender treatment

WINSTON-SALEM, North Carolina (AP) — North Carolina’s state employee health plan unlawfully discriminates by excluding treatment for transgender people by refusing to pay for hormone therapy and surgeries, as it says. did it briefly, a federal judge ruled Friday.

U.S. District Judge Loretta Biggs sided with several transgender people or their parents in saying that denying coverage of gender confirmation treatments violates the Constitution’s Equal Protection Clause and Title VII of the Constitution. civil rights law on the basis of gender.

Biggs ordered the state health plan to resume providing “medically necessary services for the treatment of gender dysphoria,” which the plan’s board provided in 2017 but did not continue through the after. Monetary damages will be considered in a trial due to begin next month, his order said. Friday’s decision considered competing petitions and experts.

“After years of fighting for fair treatment, the fact that a court is finally ruling that these health care exclusions are wrong is vindication,” said Julia McKeown, a professor at North Carolina State University. , one of the plaintiffs in a 2019 lawsuit, in a press release from Lambda Legal, which provides representation. “As government employees, all we want is equal access to health care, but we’ve been denied just because we’re transgender.”

The state health plan, which is overseen by Treasurer Dale Folwell’s office, provides medical coverage for nearly 750,000 teachers, other employees, retirees and their dependents. Folwell, who took office in early 2017, was sued, along with the health plan, its top executive and other government entities.

As the state treasurer’s office was still considering the decision Friday night, Folwell said in an interview that the board has had the ability to set benefits for decades.


Folwell said he had hoped that before Biggs made a ruling, she would “trust the people of North Carolina to have a jury trial on whether the taxpayers should pay for gender reassignment surgeries.” . The scheme’s income includes state funds and premiums.

Biggs wrote that plaintiffs’ physicians and experts, medical associations and third-party plan administrators agreed that such treatments “may be medically necessary to treat gender dysphoria in some cases.”

“The defendants’ belief that gender-affirming care is ineffective and unnecessary is simply not supported by the record,” she added.

In agreeing to cover medically necessary services for 2017, the plan’s board estimated that the annual cost of such coverage would be several hundred thousand dollars, according to the order. The U.S. Department of Health and Human Services had finalized a rule in 2016 prohibiting coverage exclusions related to gender transition. Biggs did not rule Friday on whether the plan’s actions violated the federal health care law of 2010, as the plaintiffs claimed.