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Teachers in Transgender Care Coverage Lawsuit Seek Early Win

Dec. 1, 2021, 2:48 PM

North Carolina teachers and others with state-provided employee health insurance asked a federal court to declare invalid the plan’s refusal to pay for the gender-affirming care they or their dependents require.

The blanket exclusion violates the Affordable Care Act’s Section 1557, which prohibits health-care programs that receive federal money from discriminating against people based on their sex, race, disability, ethnicity, or age, the employees told the U.S. District Court for the Middle District of North Carolina.

A 2016 administrative rule implementing Section 1557 expressly precludes categorical coverage exclusions for health-care services “related to gender transition,” the teachers said in a ...