Post was written with contributions from Paige Niler and Zachary Jones
In a potentially life-saving win for transgender rights, a federal judge in the state of New York ruled that it is illegal for Medicaid to deny coverage of any medically-necessary transition-related care for transgender people.
The class-action lawsuit filed by Bronx resident Angie Cruz was filed in 2014 to oppose a then-blanket ban on transition related health care for transgender people put in place by former Gov. George Pataki in 1998. In 2015, Governor Cuomo and the state legislature worked to lift some of these exclusions, allowing gender-affirming surgery and hormone therapy to be covered by Medicaid. Many other medically necessary transition-related surgeries, such as facial feminization surgery, were still labeled as “cosmetic” and excluded from Medicaid, despite coverage of those same procedures for other diagnoses and research demonstrating their medical need.
Two months after amending the law in 2015, the Cuomo administration issued guidelines stating that such surgeries must be covered by Medicaid if they are deemed medically-necessary. Wednesday’s ruling by Judge Jedd Rankoff found that issuing guidance was not enough and that the law itself needs to be amended so that the two do not contradict each other. Rankoff determined that excluding treatments and surgeries for a specific diagnosis is blatant discrimination and violates the federal Medicaid Act.
“While Governor Cuomo’s guidance was a major step in the right direction, this decision ensures that transgender people’s access to vital health care through New York’s Medicaid program will not depend on the whims and opinions of future governors,” said Tari Hanneman, Director of HRC’s Health Equality Program “Excluding anyone from necessary health care is cruel and harmful. This ruling reinforces the fact that denying transgender people the care they need to live and thrive is illegal discrimination.”
The lawsuit also challenged Medicaid’s blanket ban that prevents patients under 18 from receiving any transition-related care. Judge Rankoff ruled that this question will go to trial in New York state.
Access to health care can often be a confusing maze of regulations and policies. Last year, the Human Rights Campaign released resources for patients as they seek to navigate both private and public insurance plans and gain affirming and important health care.