North Carolina Transgender Surgery Ban Violates ACA, Court Rules

The North Carolina State Health Plan for Teachers and State Employees’ blanket exclusion on paying for gender-confirming care unlawfully discriminates against transgender employees and their dependents on the basis of sex, a federal court said.

This is one of several cases throughout the country disputing government health plans’ limitations on paying for medically necessary transition-related care, including surgeries such as hysterectomies and vaginoplasties.

Section 1557 of the Affordable Care Act prohibits discrimination in “any health care program or activity” that receives federal money. It expressly incorporates Title VI, which prohibits discrimination based on race, color, and national origin, and Title IX, ...