Fourth Circuit Strikes Down West Virginia Medicaid Policy on Gender-Affirming Surgeries

The U.S. Court of Appeals for the Fourth Circuit has made another significant ruling, this time striking down a West Virginia law regarding the state Medicaid Program’s coverage of certain surgeries for gender affirmation. In a recent 8-6 decision, the court ruled in favor of Shauntae Anderson, a Medicaid recipient diagnosed with gender dysphoria, who was seeking coverage for breast augmentation and vaginoplasty.

The state’s Medicaid Program currently covers gender-affirming care such as counseling, office visits, hormones, and lab work, but does not cover surgeries for the purpose of gender affirmation. Anderson’s lawsuit argued that this lack of coverage violated the Fourteenth Amendment, the Medicaid Act, and the Affordable Care Act.

West Virginia Attorney General Patrick Morrisey has stated that he plans to take the case all the way to the U.S. Supreme Court, emphasizing the state’s discretion in determining what procedures Medicaid can cover based on cost and other factors. Morrisey believes that taxpayers should not be required to pay for expensive sex-transition surgeries under Medicaid and that states should have the ability to allocate resources for the medical needs of their citizens.

This ruling follows a previous decision by the Fourth Circuit striking down the Save Women’s Sports Act, which required student-athletes to participate in sports based on biological sex rather than gender identity. The court’s decisions are sparking debate and legal challenges, with implications for healthcare coverage and transgender rights in West Virginia.