Alaska’s Policy Denying Health Care Coverage for Transgender Employees Must End

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February 19, 2020

Lambda Legal today urged the U.S. District Court for the District of Alaska to end the State of Alaska’s blanket exclusion of medically necessary transition-related surgical treatment from AlaskaCare, the state employee health care plan, and to obtain relief for Jennifer Fletcher, a state legislative librarian, who was forced to pay out of pocket for her medical treatment.

“Transgender employees should never be forced to endure what Jennifer endured, to be denied potentially life-saving treatment simply because of who they are,” Lambda Legal Counsel Tara Borelli said after today’s oral argument.

“AlaskaCare, the state health care plan, singles out transgender employees for unequal treatment by denying them coverage for medically necessary care that is readily provided for other state employees who are not transgender. That’s textbook discrimination.”

“It was stigmatizing and traumatic to have my colleagues receive coverage for their medical needs while I was denied,” said Fletcher, who also attended today’s hearing.

“It sent a clear message that the state does not equally value me as an employee, that it regards its transgender employees as other or lesser.  We should all be able to count on our employers to treat us equally, especially for something as important as our health care.”

Jennifer Fletcher is 37-year-old resident of Juneau, Alaska, who works as a legislative librarian for the State of Alaska. She has worked for Alaska since 2012 and was promoted to legislative librarian in 2014. She is transgender, which means she was assigned "male" sex at birth, but she is a woman.

The AlaskaCare plan contains a blanket exclusion of transition-related surgical treatment, which has existed in the plan since at least 1979. Because the Carter-era exclusion remains in place, Fletcher had to pay out of her own pocket for surgical treatment in 2017, even after the State’s own consultant estimated in 2016 that the cost of coverage to the State was negligible.

Beginning in 2018, the AlaskaCare plan began covering transition-related hormone therapy, recognizing that such treatment is medically necessary, but continues to categorically prohibit coverage for transition-related surgical treatment, even though it is also medically necessary.

Lambda Legal filed the lawsuit, Fletcher v. State of Alaska, in June, 2018, arguing that the State of Alaska is violating the sex discrimination prohibition of Title VII of the Civil Rights Act.

In March, 2018, the U.S. Equal Employment Opportunity Commission (EEOC) determined that there was reasonable cause to believe that the State of Alaska had violated Title VII.

All mainstream medical associations including the American Medical Association and the American Psychological Association recognize that transition-related surgical treatment can be medically necessary for an individual.

The AMA and other medical organizations have called for an end to discriminatory exclusions of medical care in public and private health insurance policies.

Tara Borelli, Peter Renn and Taylor Brown are handling this case for Lambda Legal, joined by local counsel Eric Croft of The Croft Law Office, based in Anchorage, Alaska.