US Court of Appeals (4th Cir.): States Must Include Gender-Affirming Surgery in Health Plans

Otherwise, paying for the very same procedures for non-transgendered patients violates the Equal Protection Clause of the federal Constitution. Yes, they said it in a majority opinion released today. And yes, of course there were dissenting opinions (3 of 'em). The split on the court in this en banc case was 8-6. 

For just a flavor of the principal dissenting opinion, try this:

I respectfully dissent.  The Equal Protection Clause does not license judges to strike down any policy we disagree with.  It instead grants the states leeway to tailor policies to local circumstances, while providing a carefully calibrated remedy for truly illicit discrimination.  No such discrimination appears in these cases.  North Carolina and West Virginia do not target members of either sex or transgender individuals by excluding coverage for certain services from their policies.  They instead condition coverage on whether a patient has a qualifying diagnosis.  Anyone—regardless of their sex, gender identity, or combination thereof—can obtain coverage for these services if they have a qualifying diagnosis.  And no one—regardless of their sex, gender identity, or combination thereof—can obtain coverage if they lack one.  There is therefore nothing about these policies that discriminates on the basis of sex or transgender status.

This is truly "Alice Through the Looking Glass" stuff.

The real question is what the Supreme Court will do when it gets its hands on this issue. That is a question, right? And not a foregone conclusion?

Sen. Ron Wyden (D. Ore.) Is Right About Shameless State AGs (including Ken Paxton)

From the Texas Freedom Network's Quote of the Day:

“It’s shameful that law-enforcement officials are choosing to persecute teens trying to live their lives, just to score points with far-right activists. . . ."

Senate Finance Committee Chair Ron Wyden of Oregon said, referring to the fact that four attorneys general in conservative states — including Ken Paxton — have abused their authority to investigate transgender patients and their health care.

Wyden's comments were part of a series of public statements around the release of a staff report from the Senate Finance Committee, which Wyden chairs. The report discusses concerns about the actions of four attornes general in the context of: 

• Impact on the exceptionally vulnerable LGBTQIA+ community
• Possible abuse of Medicaid program oversight powers
• Possible abuse of consumer protection, antitrust, and trafficking laws
• HIPAA

The report is a good summary that pulls together a number of shameless initiatives by these AGs.