Metro Weekly

Wisconsin must cover transgender healthcare under Medicaid, federal judge rules

Judge William Conley orders state to overturn a ban on covering transition-related health care under Medicaid

Source: Ted Eytan – Flickr

Wisconsin’s Medicaid program must cover gender affirmation health care for transgender people, a federal judge has ruled.

U.S. District Judge William Conley has overturned a ban on coverage for “transsexual surgery,” which was implemented by the state’s Department of Health Services in 1997.

It came after a lawsuit by four transgender Wisconsinites, who argued that gender affirmation treatment was necessary to treat their gender dysphoria, and as such should be covered under Medicaid, Norfolk Daily News reports.

“There is now a consensus within the medical profession that gender dysphoria is a serious medical condition, which if left untreated or inadequately treated can cause adverse symptoms, such as anxiety, depression, serious mental distress, self-harm and suicidal ideation,” Conley wrote in his 38-page ruling.

He ruled that by not covering transition-related care for transgender people, the state was violating nondiscrimination protections in the Affordable Care Act.

In addition, he noted that insurance companies that manage state Medicaid plans “acknowledge that gender-confirming hormone and surgical treatments for gender dysphoria can be medically necessary.”

Wisconsin’s DHS estimates that covering gender affirmation health care for transgender people would cost the state between $300,000 and $1.2 million per year — a small fraction of the annual Medicaid budget of almost almost $4 billion (not including federal contributions).

This latest trans health care victory follows a similar ruling by Judge Conley last year, where he ordered Wisconsin to provide health insurance coverage for transgender state employees.

Conley ruled that denying transgender state employees health insurance coverage for transition-related medical care was unconstitutional and violated federal nondiscrimination law.

A jury later awarded two transgender state employees $780,000 in damages for being denied transition-related care under the state’s health insurance plan.

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