By John Riley on May 31, 2019 @JRileyMW
On Friday, the American Civil Liberties Union and the ACLU of Iowa filed a lawsuit against the state of Iowa to block implementation of a recently passed law that exempts local governments and state agencies from having to use taxpayer dollars, including Medicaid funds, to pay for transition-related health care.
The law being challenged was passed in response to a unanimous March decision by the Iowa Supreme Court finding that a long-standing state regulation prohibiting Medicaid funds from being used to cover transition-related care was unconstitutional.
In its ruling, the court found that the provision in the Iowa Civil Rights Act prohibiting discrimination on the basis of gender identity extends to Medicaid, which is considered a “public accommodation.”
In response to that decision, Iowa lawmakers carved out a special exemption within the state’s public accommodations law that allowed government officials to refuse to allow taxpayer dollars to cover gender confirmation surgery, hormones, and other transition-related care, under the assumption that such procedures are not medically necessary.
That exemption, which was attached to a routine budget bill, was signed into law by Gov. Kim Reynolds (R) in May.
Friday’s lawsuit, filed on behalf of the LGBTQ rights organization One Iowa and two transgender plaintiffs: Aiden Vasquez, of southeast Iowa, and Mika Covington, of central Iowa, alleges that the exemption violates transgender people’s right to equal protection under the U.S. Constitution, and their inalienable right to liberty, safety, and happiness under the Iowa Constitution.
The lawsuit also argues that the law violates Iowa’s “single subject rule” requiring that all legislation passed by the Iowa General Assembly only deal with one subject “and matters properly connected therewith.”
Under the “single subject rule,” if a bill includes a separate subject that is not listed in its title, any provision dealing with the unlisted topics is considered void.
Both Vasquez and Covington are transgender, qualify for Medicaid, and have doctors who agree that receiving gender confirmation surgery is necessary to treat their gender dysphoria.
Every mainstream medical association, including the American Medical Association, the American Psychological Association, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the National Association of Social Workers, and the World Professional Association of Transgender Health, have deemed gender confirmation surgery as medically necessary for treating some people’s gender dysphoria.
“This law reverts the State of Iowa back to its longstanding discriminatory policy and practice of denying transgender Iowans on Medicaid coverage for gender-affirming surgery, Rita Bettis Austen, the legal director of the ACLU of Iowa, said in a statement. “The law brings significant harm to our clients and others who rely on Medicaid and who desperately need this surgery. This is a matter of life and death.”
Bettis Austen also said the law has no basis in medicine or science, and violates the right to equal protection under the Iowa Constitution because it discriminates against people due to their gender identity.
The lawsuit comes one week after the Trump administration released a new regulation that would roll back LGBTQ protections within the Affordable Care Act by explicitly defining its prohibitions on sex-based discrimination in health care and insurance coverage as pertaining only to instances where someone is discriminated against based on their assigned sex at birth.
“No one should be denied the medical care they need, and that includes transgender individuals,” Daniel Hoffman-Zinnel, the executive director of One Iowa, said in a statement. “A patient’s health should always come first. Denying transgender people the medically necessary health care they need, as directed by their doctor, can contribute to depression, anxiety and increased risk of suicidal thoughts. Make no mistake, this law threatens lives.”
Vasquez said he was bringing the lawsuit in order to ensure that he and other transgender people are able to access medically necessary care.
“Now it’s time to join the front lines to stand up for my equality and wholeness, as well as for the rights of other transgender Iowans,” he said in a statement. “Tragically, society shames transgender people just for being who they are. But I’m not hiding anymore. I’m determined to help myself, and in that way, help others.”
“Gender-affirming surgery is not cosmetic surgery,” Covington said in a statement. “Getting the gender-affirming surgery that my doctors have determined is medically necessary for me will do nothing less than give me my life back. It will help me build a life in which my body is in harmony with my gender, so I can overcome the depression, lack of confidence, isolation, and other problems my gender dysphoria causes.
“It was very painful for me when the Iowa legislature passed this law,” Covington added. “All Iowans, regardless of income level, have the right to have medically necessary health care without discrimination because of who they are. It’s wrong to deny Iowans on Medicaid like me their medically necessary care just because we are transgender. This surgery is literally life-saving.”
By John Riley on April 2, 2024 @JRileyMW
Idaho Republican Gov. Brad Little signed a bill into law prohibiting Medicaid and state employee health plans from covering the cost of gender-affirming medications and procedures for low-income transgender adults and minors.
House Bill 668 declares that public funds "shall not reimburse or provide coverage for any surgical operation or medical intervention...for purposes of altering the appearance of an individual in order to affirm the individual's perception of the individual's sex in a way that is inconsistent with the individual's biological sex."
The bill contains exemptions for certain types of surgical operations or medical interventions, such as those deemed medically necessary; those meant to force intersex people or those with "a medically verifiable genetic disorder of sex development" to conform to binary bodily stereotypes; and those used to help a person "de-transition" or to treat an "infection, injury, disease or disorder that has been caused or exacerbated by" gender-affirming surgery.
By John Riley on April 8, 2024 @JRileyMW
University of South Carolina women's basketball coach Dawn Staley grabbed headlines this past weekend when she weighed in on the side of allowing transgender athletes to participate in sports.
On April 6, the day before her Lady Gamecocks were to play in the NCAA Division I "March Madness" Tournament Championship game against Iowa, Staley -- who freely offers her opinion on any topic, regardless if her comments may offend some people -- was asked about her position on transgender athletes competing in women's sports.
The question came from Dan Zaksheske, a reporter for OutKick, a website with a strong conservative viewpoint that markets itself as an "everyman" alternative to mainstream sports news outlets.
By John Riley on April 16, 2024 @JRileyMW
On Tuesday, April 16, a federal appeals court voted to block a West Virginia law banning transgender student-athletes from competing on teams that align with their gender identity.
The 4th U.S. Circuit Court of Appeals found that the ban, which was signed into law by Republican Gov. Jim Justice in April 2021, violates the rights of transgender students under Title IX, the federal statute that prohibits sex-based discrimination.
The law was challenged by a slew of civil rights and LGBTQ organizations on behalf of B.P.J., a 13-year-old transgender girl and middle school track and cross-country athlete who wishes to compete as a girl.
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