Judge says Florida should not deny trans coverage but won’t enforce during appeal

Update:

• A federal judge in Florida denied a request to enforce a ruling blocking a Florida law that bans Medicaid payments for puberty blockers and cross-sex hormones.
• The Florida Agency for Health Care Administration (AHCA) must pay for treatments for the four plaintiffs while the case is under appeal, U.S. District Judge Robert L. Hinkle writes in his order denying the request.
• The lawsuit is not a class action, and it is too late to add additional plaintiffs, Judge Hinkle says.
• The AHCA cannot categorically deny trans coverage based on the law and must individually consider the medical necessity of each case based on its own merits, Judge Hinkle writes.

Florida gender-affirming care overview: 

• Who: A Florida federal judge has sided with a group of transgender Medicaid plan participants who filed a lawsuit against the secretary of the Florida Agency for Health Care Administration (AHCA).   
• Why: The judge ruled the AHCA cannot deny Medicaid payments for certain gender-affirming care. 
• Where: The case is in Florida federal court.

(June 27, 2023)

A federal judge in Florida has ruled the state cannot categorically ban Medicaid payments for certain gender-affirming care, such as puberty blockers, hormone therapy and surgeries.

The decision, which follows a May bench trial, prevents the Florida Agency for Health Care Administration (AHCA) from preventing the administration of the gender dysphoria treatments for trans individuals and requires it to approve Medicaid coverage. 

“Gender identity is real,” the judge wrote, in his findings of facts and conclusion of law. “Many people with (the opposite view) tend to disapprove all things transgender and so oppose medical care that supports a person’s transgender existence.” 

A group of transgender Medicaid participants and beneficiaries — including two adults and two minors — filed the lawsuit.

“In this litigation, the defendants have explicitly acknowledged that this view is wrong and that pushing individuals away from their transgender identity is not a legitimate state interest,” the judge wrote. 

Plan participants argued exclusionary rule cost them coverage for gender-affirming care

The group of transgender Medicaid participants and beneficiaries argued last September that Florida’s low-income health care program and the AHCA’s exclusion of treatments for gender dysphoria was unconstitutional and violated the Affordable Care Act’s nondiscrimination law, Law360 reports. 

The AHCA, prior to the rule being put in place, had held the position that it would consider whether a procedure was medically necessary on a case-by-case basis, which allowed many transgender individuals in the state to have their gender-affirming care covered. 

Since the exclusionary rule, many transgender individuals have lost their Medicaid coverage for treatment that the plan participants argue is necessary for their physical and mental health and overall well being. 

The AHCA had previously made a bid for summary judgment, a motion which was denied by the judge only days before the bench trial began, according to Law360. 

In April, President Joe Biden’s administration proposed a new rule that would prohibit schools from being able to “categorically” ban transgender student athletes from being able to participate in school sports. 

What are your thoughts on the judge’s decision? Let us know in the comments. 

The Florida trans care case is Dekker, et al. v. Weida, et al., Case No. 4:22-cv-00325, in the U.S. District Court for the Northern District of Florida.

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