Court ruling limits adult gender-affirming Medicaid coverage

By AZ Mirror

A U.S. appeals court ruling last month that upheld West Virginia’s ban on Medicaid coverage for adult gender-affirming surgeries could embolden other states seeking to impose similar restrictions.

The 4th U.S. Circuit Court of Appeals in March overturned a lower court decision in Anderson v. Crouch that had reversed West Virginia’s ban on Medicaid coverage for adult gender-affirming surgeries. The lower court ruled that the ban was discriminatory.

The decision came after the Supreme Court last year upheld Tennessee’s ban on gender-affirming care for youth in U.S. v. Skrmetti. The court then vacated several lower courts’ rulings and handed back cases — including West Virginia’s — for reconsideration in light of the high court’s opinion in the Tennessee case.

In response, the new West Virginia ruling extends the Supreme Court’s reasoning to the state’s ban on Medicaid coverage for adult gender-affirming surgery. The judges wrote West Virginia’s policy applies only to certain procedures, contending that it doesn’t target certain people or a protected status such as sex.

In a unanimous opinion, the three-judge appeals panel wrote, “(I)t is not irrational for a legislature to encourage citizens ‘to appreciate their sex’ and not ‘become disdainful of their sex’ by refusing to fund experimental procedures that may have the opposite effect.” The panel added, “The Supreme Court’s decision in Skrmetti forecloses any argument to the contrary.” The plaintiffs have filed a request for a rehearing by a full panel.

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