Refusing Trans Insurance Coverage is Unlawful, Court Rules
filed a lawsuit against West Virginia officials on behalf of a Medicaid participant, Christopher Fain, who was denied coverage for gender confirmation surgery.
That same lawsuit also previously challenged a similar exclusion contained in West Virginia’s state employee health insurance plan on behalf of two state employees who could not obtain coverage for gender-affirming treatments, either for themselves or their dependents.Lambda Legal subsequently added additional transgender plaintiffs to the case, including Shauntae Anderson.The state employee plaintiffs’ claims were eventually resolved by a 2022 settlement with The Health Plan of West Virginia, Inc., which removed its exclusion on gender-affirming care.The lawsuit subsequently resumed, challenging only the Medicaid exclusion.In August 2022, a federal judge ruled that West Virginia’s Medicaid program could no longer discriminate against transgender recipients by failing to cover the cost of surgical care deemed medically necessary for treating a person’s gender dysphoria.
In North Carolina, Lambda Legal and the Transgender Legal Defense and Education Fund (TLDEF), along with two national law firms, sued North Carolina officials on behalf of several current and former state employees and their dependents who were denied coverage for medically necessary gender-affirming care under an insurance exclusion in their employer-provided health plan.
In June 2022, a federal judge ruled in favor of the state employees and their dependents, finding that the exclusion violated the Equal Protection Clause of the U.S.
