A federal judge recently ruled that Wisconsin’s exclusion of health insurance coverage for medically necessary gender reassignment surgery violates the federal Civil Rights Act. U.S. District Judge William Conley said the denial of coverage for two University of Wisconsin-Madison employees who are transitioning to female is a form of prohibited sex discrimination.
Conley said the coverage exclusion also violates a provision of the Patient Protection and Affordable Care Act that prohibits discrimination.
The state Group Insurance Board (GIB) relented last month, voting to reverse itself and cover gender-reassignment surgery and related medical care.
This past summer, Conley issued a preliminary injunction in a separate case that stopped the state from enforcing a rule that bars state Medicaid funds being used for gender-confirming surgery for those with gender dysphoria (distress experienced when a person’s gender identity and birth gender are not in agreement).
In his more recent ruling, Conley said that remedies available to the plaintiffs will be determined later. Compensatory and punitive damages will also be determined in the future, the jurist decided.
One of the two UW employees seeks compensation for surgery she has undergone and paid for herself after her claim for coverage was rejected.
A little more than two years ago, GIB voted to stop excluding transition-related care, but was asked a month later by the state Department of Justice to reinstate the exclusion.
Conley says in his ruling that the state’s cost-related reasons for denying coverage were “immaterial” and that the evidence shows that GIB barely discussed cost when it reinstated the exclusion.
The ruling makes it clear that justice can be won by individuals who challenge institutional and workplace discrimination.
