Injured - The FindLaw Accident, Injury and Tort Law Blog

Federal Judge: Wisconsin Can't Block Insurance From Covering Transgender Health Care Costs

Under Wisconsin's administration of health insurance benefits,"[p]rocedures, services, and supplies related to surgery and sex hormones associated with gender reassignment" were excluded from coverage. But a federal judge recently ruled the exclusion violated antidiscrimination measures in the Affordable Care Act, and a jury just awarded two transgender women $780,000 after they were denied coverage for hormone therapy and surgery relating to their gender transitions.

On top of that, Wisconsin's insurance board voted to allow the coverage beginning January 1, 2019.

Differential Treatment

Shannon Andrews, a cancer researcher at the UW School of Medicine and Public Health, and Alina Boyden, a graduate student, filed the lawsuit against the state with the help of the American Civil Liberties Union last year. Andrews was forced to drain her retirement savings to pay for treatment after her claims were denied, and Boyden was unable to afford gender confirming surgery without insurance coverage. Both claimed Wisconsin's ban on transgender coverage violated sex discrimination protections in Title VII of the Civil Rights Act and the ACA.

"Whether because of differential treatment based on natal sex, or because of a form of sex stereotyping where an individual is required effectively to maintain his or her natal sex characteristics," wrote U.S. District Judge William Conley, "the Exclusion on its face treats transgender individuals differently on the basis of sex, thus triggering the protections of Title VII and the ACA's antidiscrimination provision."

Transgender Discrimination

Once Judge Conley found liability in favor of Andrews and Boyden on their Title VII and ACA claims, it was just a matter of damages. "Discrimination comes with a cost," said legal director for the ACLU of Wisconsin Larry Dupuis, "and for the state of Wisconsin the bill has come." The jury awarded Andrews $479,500 and Boyden $301,000, most of the awards being for emotional pain and suffering. Andrews had paid about $79,000 for two surgeries due to the lack of insurance coverage, according to Dupuis, while Boyden paid about $1,000 for hormones.

While the present case applies to state employees, Conley also ruled in a separate case that Wisconsin couldn't bar the use of Medicaid funds to pay for transgender surgery.

Related Resources: