Health Plans Must Cover Transgender Care, Fourth Cir. Says (2)

Two states’ health plans’ blanket coverage exclusions for gender-affirming care are unconstitutional, the full Fourth Circuit said Monday.

A North Carolina state employee health plan violates the 14th Amendment’s equal protection clause by refusing to pay for medically necessary gender-dysphoria treatments, a slim majority of the US Court of Appeals for the Fourth Circuit said.

And West Virginia’s Medicaid program is unconstitutional to the extent that it pays for some gender-affirming care, but not for surgeries that are typically covered for non-transgender patients, the court also said. The exclusion violates the Affordable Care Act and the Medicaid Act, it said. ...