The North Carolina Employee Health Plan's exclusion of gender-affirming care for transgender employees and their families is discriminatory, the U.S. Court of Appeals for the Fourth Circuit has ruled.
Monday's 8-6 ruling upheld a lower court's ruling that the state violated the right of state employees to access state health insurance by denying gender-affirming care to people with gender dysphoria. .
Justice Roger Gregory, speaking for the majority, said, “In addition to discrimination based on gender identity, exclusion also discriminates on the basis of sex.”
Lambda Legal and the Transgender Legal Defense and Education Fund filed a lawsuit challenging the exclusion on behalf of seven plaintiffs in 2019.
““This powerful victory in court is gratifying not only for me but for all other state employees across North Carolina who have suffered discrimination,” Julia McCune, an associate professor at North Carolina State University, said in a statement.
“As public servants, all we want is equal access to health care, but we were denied just because we are transgender. We are relieved that the court has ruled that this discrimination is illegal. I hope you will finally stop fighting in vain to deny us our rights and stand on the side of equality.'' said in a statement.
Health insurance for state employees has begun to be covered. Medically Necessary Transgender Care in 2017reported NC Newsline. When State Treasurer Dale Falwell was elected, he decided to end his coverage.
In 2022, U.S. District Judge Loretta Biggs ruled against the exclusion. After Mr. Falwell appealed, the health plan reinstated coverage.
On Monday, a statement from Mr. Falwell's office cited the dissenting opinion and expressed hope that the majority's decision would be “modified by the United States Supreme Court.”
Falwell's statement said health plans are at risk of bankruptcy and must provide the most benefit to the most people with finite resources. This health plan covers approximately 750,000 people.
The majority opinion called the argument that treatment is too expensive “a non-starter.”
The ruling comes as North Carolina and other states pass laws aimed at gender-affirming health care and sports participation.
Last year, the North Carolina General Assembly passed a law banning gender-affirming care for people under 18, banning transgender female athletes from participating in sports that correspond to their gender identity, and banning children from playing sports that correspond to their gender identity. Schools are now required to tell parents if they wish to use their child's name or pronouns.
