Skip to comments.Iowa court finds Medicaid ban on transgender surgery is unconstitutional
Posted on 06/07/2018 10:17:43 PM PDT by iowamark
An Iowa court has determined that the states ban on Medicaid coverage for medically necessary surgical care for transgender residents is unconstitutional.
Chief District Judge Arthur E. Gamble of the Des Moines-based Fifth Judicial District of Iowa found that the Iowa Department of Human Services ban on surgical coverage violates both the Iowa Civil Rights Act and the states constitution. In his opinion, Gamble ordered DHS to immediately approve the womens request for pre-approval of coverage under Medicaid.
Both women, Carol Ann Beal, 42, of northwest Iowa, and EerieAnna Good, 27, of the Quad Cities, have been diagnosed with gender dysphoria and legally changed their names, and had their birth certificates, drivers licenses, and Social Security cards changed to reflect their correct names and gender identity. Both women also began hormone therapy, and were advised by their doctors to pursue surgery for treatment of their gender dysphoria.
Iowas DHS office rejected both womens requests for coverage, citing the ban. Afterwards, the women enlisted the help of the American Civil Liberties Union and ACLU of Iowa, and sued, arguing that the ban was unconstitutional.
Lawyers from the ACLU and ACLU of Iowa pointed out that Medicaid otherwise provides coverage for medically necessary surgeries utilized by transgender people, that would normally be covered had the individual in question been cisgender. Gamble echoed this in his opinion. DHS does not explain why the medical necessity of requests for sex reassignment surgeries could not simply be evaluated under the same criteria as other requested surgeries or treatment of non-transgender individuals, he writes. Petitioners have provided clear medical documentation outlining the medical necessity of their requested procedures. Thus, the Court sees no reason why DHS and the MCOs need an additional and indefinite period of time to develop new and separate criteria for evaluating requests by transgender individuals as opposed to simply applying the existing criteria.
Todays decision is historic for civil rights in Iowa, because it recognizes for the first time in a court decision what weve long known, that transgender Iowans are protected by the Iowa Constitutions guarantee of equal protection, as well as by the Iowa Civil Rights Act, Rita Bettis, the legal director of the ACLU of Iowa, said in a statement.
We are so relieved for our brave clients that they can finally get the gender confirming surgical care that all their doctors agree is medically necessary for them, Bettis added. We are honored to represent them in their long journey for themselves and for all other transgender Iowans to be treated equally and fairly under the law.
In 2014, the U.S. Department of Health and Human Services invalidated its ban on Medicare coverage for surgery and other transition-related care. Since then, several states have begun eliminating their state Medicaid bans on transition-related surgery, and individuals in other states, including Minnesota and Wisconsin, have sued their state health departments to eliminate the Medicaid exclusion.
The court has brought Iowa in line with the current understanding of the critical needs for transgender people, John A. Knight, a senior staff attorney with the national ACLU, said in a statement. By recognizing and rejecting the historic discrimination faced by transgender people, the court is opening the door to the life-saving medical care and necessary gender-affirming treatment that transgender people are too often denied. The court found that when the Medicaid ban was first implemented more than two decades ago, much less was known about gender dysphoria, and gender identity was not protected under the Iowa Civil Rights Act. Gender identity (as well as sexual orientation) has since been added as a protected class, and the Iowa Constitution guarantees equal protection for all Iowa residents, regardless of characteristics that are covered in the Civil Rights Act. Therefore, the court had no choice but to find the ban unconstitutional.
We are thrilled that our states unconstitutional ban on transition-related surgical care has been struck down, Daniel Hoffman Zinnel, the executive director of LGBTQ rights organization One Iowa, said in a statement. Through our work with transgender Iowans, we have seen firsthand how powerful, life-changing, and absolutely essential gender-affirming surgery can be for transgender people grappling with gender dysphoria. This decision will, quite literally, save lives.
This has been a long time coming, Beal said in a statement. Im so glad I can get the care I need, and Im glad that other Iowans can now get the same care. Transition-related care is a medical issue, plain and simple. Its like any other surgery that a doctor would recommend for you or a family member. Public or private insurance would pay for it, and youd just do it and move ahead with your life.
I look forward to the day when someone fighting to get the transition-related medical care they need isnt in the news because they had to go to court to fight for it. But Im doing it because someone needs to be the trailblazer here, she added. I want to make it easier for the younger people who need this surgery, so they dont have to go through the struggles I have had to go through.
Dr. Paul McHugh: “Transgender Surgery isn’t the solution”
The State of Iowa will almost certainly appeal this ruling.
Meanwhile I can’t get a prosthetic from the V.A.
It’s ‘elective’ surgery and should not be covered.
I want youth confirming hair replacement.
Then your not going to the right place....try another channel.
I’m holding back on contacting Ted Cruz unless I’m totally denied.
Medicaid is between 70% and 90% federal dollars, so dont laugh, youre paying for it.
Send them to a Psychiatrist, not a Surgeon.
I cannot get covered oral surgery/reconstruction for multiple benign tumors because it would be dental care and cosmetic.
Yup and at er McHugh was no longer in charge Hopkins deserted the science based decision and has once again resumed the practice of cutting off normal organs
Do you have a Veterans’s Advocate assigned to you?
Some VA Hospitals, such as mine in San Francisco, have staff to help answer certain questions, or contact certain providers of care. Usually, a vet has to ask for an advocate’s assistance. Most do not. Most don’t even know of such a choice being available.
Have your primary doctor try getting a reaction from them.
If you are eligible for a certain prosthetic, you should be getting it, or at least an estimated date of availability.
Some prosthetics offices are very quiet and very slow.
They may have some volunteer at the front desk who does not really know what their talking about and may be too lazy to get up from the chair to ask about it. That I have seen myself. Call within the first two hours of the morning or right after that office takes lunch. They most likely will take a full lunch and lock the door. Good Luck!
I want youth confirming hair replacement.
Just tell them that you self-identify as a young man with a head full of hair. After all, its your constitutional right to have them pay your medical expenses needed for you to be whatever you identify as.
Insane. (And there are people who have real needs but instead a judge wants us to piss away tons of our tax money in this bullbleep?
Damned Black-Robed Judiciarchs.
Oh, oh, did anyone ask the Hawaiian Judge about this?
Ergo when gender reassignment surgery leaves the patient depressed and suicidal two years later, steps off a 7th floor balcony to end their misery, the state of Iowa Medicaid system can be sued for wrongful death along with the doctors who perform the genital torture?
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