HomeUSA NewsIowa Can't Block Medicaid Coverage For Gender Confirmation Surgery, Judge Rules

Iowa Can’t Block Medicaid Coverage For Gender Confirmation Surgery, Judge Rules

A court determined Friday that an Iowa statute prohibiting Medicaid from financing gender confirmation surgery violates both the Iowa Civil Rights Act and the Iowa Constitution.

Polk County District Court Judge William P. Kelly ruled that the provision of the law that excludes protection for surgery should be removed from the state’s organizational code, and that the rest of the law should be interpreted and implemented to allow transsexual Iowans to obtain coverage for medical necessity surgery to treat gender dysphoria and other diagnoses.

In April, the American Civil Liberties Union of Iowa filed a lawsuit against the state on behalf of two transgender Iowans, Aiden Vasquez and Mika Covington, who were refused insurance coverage for gender-affirming procedures.

The two Iowa residents are Medicaid patients, and their doctors agreed that gender-affirming surgery was required to address their gender identity disorder. When recommended by a doctor, all major medical societies believe that transition-related treatment, including procedures, is medically required.

The ACLU of Iowa’s legal director, Rita Bettis Austen, said in a statement that she is happy the court has ordered the state to enable her clients to have medically necessary procedures.

After the Iowa Supreme Court ruled that an Iowa Department of Human Services regulation that prohibited using Medicaid funds to cover the surgeries was discriminatory under the Iowa Civil Rights Act, Republicans in the Iowa Legislature passed the law excluding gender confirmation surgeries from Medicaid coverage in 2019.

In 2007, the Iowa Civil Rights Act included sexual orientation and gender identity as protected classes, providing LGBTQ Iowans, including transgender Iowans, with extra legal rights against discriminatory practices, employment, housing, and public facilities.

Gender identification is a person’s internal, firmly held sense of gender, which differs from the sex given at birth for transgender persons.

Republican Gov. Kim Reynolds signed the bill in 2019 and has previously maintained the restriction on using government dollars to perform gender confirmation operations.

This is the second lawsuit filed against the law. In the earlier case, the Iowa Court of Appeals concluded last summer that the plaintiffs had not exhausted the internal Medicaid appeals procedure or been refused coverage. The Iowa Department of Human Services has since denied coverage to both claimants. The ACLU filed the present complaint at that time.

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