New lawsuit alleges Medicaid exemption for transgender people in Iowa is discriminatory and violates civil law

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The Iowa ACLU has filed a lawsuit on behalf of Aiden Vasquez, pictured here, alleging that a state law that excludes surgeries related to the transition from Medicaid coverage discriminates against transgender people from Iowa. (Photo courtesy of the Iowa ACLU).

In another salvo against the state in its multi-year battle on behalf of transgender people in Iowa, the Iowa ACLU on Thursday announced it was pursuing a state law banning Medicaid coverage for surgeries. affirming the genre.

The civil liberties organization filed a lawsuit in Polk County District Court on behalf of two transgender people from Iowa, alleging that a law excluding surgeries related to the transition of public insurance funds is unconstitutional and is a violation of Iowa Civil Rights Act.

This is the third time the Iowa ACLU has filed suit against the state over policies that prevent Medicaid from covering medically necessary treatment for transgender people in Iowa, officials said Thursday. ACLU to journalists.

“We’re frustrated, customers are frustrated, and we know the people of Iowa are frustrated that the state continues to revive this discriminatory rule,” said Rita Bettis Austen, legal director of the ACLU of the ‘Iowa.

The lawsuit seeks to overturn a law passed by the 2019 Iowa Legislature that amended the Iowa Civil Rights Act to allow any state or local government entity to refuse to use public insurance, including including Medicaid, to pay for transitional surgeries.

The lawsuit is a reiteration of an earlier lawsuit filed by the Iowa ACLU on behalf of Aiden Vasquez of central Iowa and Mika Covington of southeast Iowa, both transgender and eligible for Medicaid.

This earlier action was dismissed by the Iowa Court of Appeals in August 2020. The court has not upheld the law, but since neither individual has yet been denied Medicaid coverage under the new rule, the dispute was “speculative”, according to the court. .

Vasquez has since been denied coverage for transition care, Bettis Austen said. She added that Covington would join the lawsuit if she was also denied Medicaid coverage.

“It’s hard to know that the state has gone out of its way to discriminate against me and block my medical care just because I’m transgender, while other Iowans on Medicaid are able to get coverage for surgeries whose they need, ”Vasquez said in a statement.

Mika Covington was part of a previous lawsuit by the Iowa ACLU against state policies banning Medicaid coverage for transitional surgeries. Covington, who is transgender and qualifies for Medicaid, will join the latest civil liberties union lawsuit if she is denied coverage. (Photo courtesy of the Iowa ACLU).

The two Iowans seek care to treat gender dysphoria, or distress or discomfort that may arise in people whose gender identity differs from their physical characteristics. While others may seek other forms of gender affirmation, medical and surgical routes are common types of gender affirmation care.

Gender dysphoria can lead to serious risk factors, including depression, anxiety, and an increased risk of death by suicide.

Vasquez said that not being able to access this medical care “threatened my mental well-being”.

“I am a man, but in a body that does not reflect who I am,” he said. “This is why this surgery will be life changing.”

Major medical groups, including the American Medical Association and the American Psychological Association, agree that surgeries and other transitional care are medically necessary when prescribed by a physician.

“Being able to finally get the surgery that my doctors have deemed medically necessary for me will do nothing less than bring me back to life,” Covington said in a statement. “It will help me build a life in which my body is in harmony with my gender, so that I can overcome depression, lack of self-confidence, isolation and other issues caused by my gender dysphoria. “

Battles have taken place before

The measure was passed as an amendment to a health budget bill at the end of the 2019 legislative session.

This rule was in direct response to a March 2018 Iowa Supreme Court ruling that struck down an administrative code that limited Medicaid dollars for gender-affirming surgeries. In their ruling, the judges ruled that denying Medicaid reimbursement for surgeries to treat gender dysphoria violated protections under Iowa’s civil rights law. The law has prohibited discrimination based on gender identity or sexual orientation since 2007.

The decision was a first by the state Supreme Court upholding Iowa’s transgender rights under the Iowa Civil Rights Act, according to Iowa ACLU officials at the time.

The organization filed a lawsuit in 2017 on behalf of two other Iowans, Carol Ann Beal and EerieAnna Good, who were denied coverage for gender-affirming surgeries by their managed care organizations – the companies of insurance who administer the state’s Medicaid program.

The Iowa ACLU had also been involved in previous litigation against private insurers for access to gender-affirming surgeries and represented a transgender Iowan who won a discrimination case against the state in early 2019. .

Jesse Vroegh, a former Iowa Prison Department nurse who identifies as a male, filed a lawsuit alleging that the Iowa Public Sector Employee Health Insurance Plan contained a specific exclusion for transitional surgeries.

The lawsuit also alleged that the department denied his requests to use the men’s washroom and changing rooms at the Iowa Women’s Correctional Facility where he worked. Finding in his favor, a jury awarded Vroegh $ 120,000 in damages.

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