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Judges Appear Split in Fourth Cir. Trans Care Insurance Dispute

Jan. 25, 2023, 8:14 PM

The North Carolina employee health insurance plan’s blanket refusal to pay for gender-conforming care sought by transgender state employees or employees’ transgender dependents is being considered by the Fourth Circuit following oral arguments Wednesday.

At issue in the US Court of Appeals for the Fourth Circuit is the North Carolina Health Plan for Teachers and State Employees’ coverage exclusion for gender-confirming care, which a federal trial judge held violates the US Constitution’s equal protection clause and, in a more recent decision, the Affordable Care Act’s anti-bias provision, Section 1557.

This is the first case to put the state employee ...