West Virginia will take its fight over whether its Medicaid program must
cover gender-affirming surgeries to the Supreme Court, the state�s
Republican attorney general announced Thursday.

�Once again, the state of West Virginia is going to the U.S. Supreme
Court,� Attorney General Patrick Morrisey said at a news conference in
Bridgeport, W.Va.

The announcement is the latest development in a legal battle that�s been
ongoing since 2020, when three transgender men alleged in a class-action
lawsuit that West Virginia�s refusal to cover transition surgeries
violates federal antidiscrimination laws.

A federal judge in 2022 ordered the state to cover the procedures, a
decision the 4th U.S. Circuit Court of Appeals affirmed in April. In the
4th Circuit ruling, Judge Roger Gregory, an appointee of former President
Clinton, wrote that West Virginia�s exclusion � as well as a similar North
Carolina policy � is �obviously discriminatory� and violates the Medicaid
Act and the Affordable Care Act.

Morrisey and other state officials maintain West Virginia�s policy barring
coverage of gender-affirming surgeries reflects cost concerns, not an
antitransgender animus.

�We�re not a rich state. We can�t afford to do everything, and that�s one
of the challenges that we have with this mandate. There�s only so much
money to go around, and spending money on some treatments necessarily
takes it away from others,� Morrisey, who is running for governor of the
state, said Thursday.

�Our state�s Medicaid program made a reasonable decision to reserve scarce
funding for medically necessary treatments, not elective surgeries,� he
said, adding that the decision was made to ensure adequate resources for
people with heart disease, diabetes and other medical conditions.

Major medical organizations argue gender-affirming care is medically
necessary, though not every trans person chooses to transition medically
or has access to care. In April, Shauntae Anderson, a transgender woman
and plaintiff in the class-action lawsuit challenging West Virginia�s
Medicaid exclusion, said her state�s refusal to cover gender-affirming
surgeries is �deeply dehumanizing� and needlessly restricts access to
essential health care.

Morrisey, whose run for governor is endorsed by former President Trump,
continues to veer to the right on transgender issues, often referring to
transgender women as �men� and capitalizing on misinformation surrounding
gender-affirming health care in campaign ads.

Thursday�s appeal to the Supreme Court, he said, could have national
significance.

�This is a case that we think should be heard by the U.S. Supreme Court
because it�s interpreting a major federal law, the Medicaid Act, and it
presents a nationally important constitutional question: whether Medicaid
or any state-related insurance program must cover all transgender care,�
Morrisey said Thursday.

The request is West Virginia�s third Supreme Court filing over the past
month. The state is also asking the court to review a lower court ruling
preventing it from enforcing a 2021 law that bars transgender student-
athletes from competing in sports and to block the Environmental
Protection Agency�s new power plant rules.

The Supreme Court last year rejected a request by Morrisey to allow the
state to enforce its trans athlete ban, though Justices Samuel Alito and
Clarence Thomas said they would have heard the case.

https://thehill.com/regulation/court-battles/4793516-west-virginia-
supreme-court-medicaid-gender-affirming-surgery/