A unanimous ruling from the Iowa Supreme Court may be drastically changing the landscape of Medicaid coverage.
According to the judicial body, Medicaid must cover gender transition surgeries because the surgeries are medically necessary.
From the Washington Examiner:
EerieAnna Good and Carol Ann Beal, transgender women backed by the ACLU, had sued the Iowa Department of Human Services for its policy against funding transition surgeries, calling it discriminatory. The DHS had considered transition surgery to be cosmetic without medical purpose.
Iowa Supreme Court Justice Susan Christensen wrote that the DHS’ existing “bar on Medicaid coverage for gender-affirming surgical procedures discriminates against transgender Medicaid recipients in Iowa” under Iowa civil rights laws. In 2007 Iowa legislators added “gender identity” to the Iowa Civil Rights Act.
According to the report, the Supreme Court’s decision upheld a lower court’s decision to overturn the ban. The lower court’s decision was appealed by the state.
As the Des Moines Register reports, the average cost of a gender-reassignment surgery can range between $20,000 and $100,000 which puts it well out of the range of a person who qualifies for Medicaid.
The court’s unanimous decision struck down the administrative code governing Medicaid in Iowa that classifies transition-related surgeries as “cosmetic, reconstructive or plastic surgery” and explicitly bans “surgeries for the purpose of sex reassignment.”
In affirming a district judge’s decision, Justice Susan Christensen wrote that the “express ban on Medicaid coverage for gender-affirming surgical procedures” contradicted the gender-identity protections in the Iowa Civil Rights Act.
Gender identity — or the deeply held sense of who one is, which may differ from the sex organs with which one was born — and sexual orientation were added to the Iowa Civil Rights Act as protected classes in 2007.
Under that statute, transgender Iowans have legal protections against discrimination in education, employment, housing and public accommodations. Medicaid, a state and federally funded program, is considered a public accommodation.
But the court stopped short of ruling that this was a violation of the equal protection clause in the Iowa Constitution.
Note: The author of this article has included commentary that expresses an opinion and analysis of the facts.