Iowa Supreme Court Says Medicaid Must Cover Care for Transgender People

DES MOINES, Iowa – The Iowa Supreme Court today issued a unanimous ruling that the Iowa Department of Human Services discriminated against two women by denying their Medicaid claim for transition-related care because they are transgender.

EerieAnna Good and Carol Beal, represented by the American Civil Liberties Union, are two women whose medical providers determined that surgery was medically necessary to treat their gender dysphoria and requested approval for Medicaid coverage for the surgery. Without that coverage, the costs of surgery were outside of their reach. Both were denied coverage due to a regulation from the Department. The two women filed lawsuits under the Iowa Civil Rights Act (ICRA) and the Iowa Constitution.

The Iowa Supreme Court rejected the Department’s argument that gender-affirming surgery is “‘cosmetic, reconstructive, or plastic surgery’ that is ‘performed primarily for psychological purposes.’” and concluded that the “exclusion of Medicaid coverage for gender-affirming surgery violates the ICRA.” Having reached that conclusion, the court concluded that it did not need to reach Ms. Good’s and Ms. Beal’s constitutional claims.

John Knight of the ACLU’s LGBT & HIV Project had the following reaction:

“The ruling means that many transgender Iowans will be able to obtain life-saving medical care that they were unable to get in the past. Denying health care coverage to someone because they are transgender is wrong and extremely harmful. We are thrilled that the Iowa Supreme Court rejected the Department’s effort to minimize the importance of this surgery by labeling it as cosmetic and unanimously struck down this harmful ban on necessary health care.”

The decision is available here: https://www.aclu.org/legal-document/good-v-iowa-dept-human-services-supreme-court-order

More information is available here: https://www.aclu.org/cases/good-v-iowa-dept-human-services

This statement is online here: https://www.aclu.org/news/iowa-supreme-court-says-medicaid-must-cover-care-transgender-people