Lambda Legal to 4th Circuit: Affirm Ruling Striking West Virginia Medicaid Ban on Gender-Affirming Care

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March 7, 2023

Today, the U.S. Court of Appeals for the Fourth Circuit heard oral argument in an appeal brought by West Virginia seeking to reverse a district court decision requiring the State's Medicaid program to treat transgender people’s healthcare needs equally.  

The appeal comes in the lawsuit filed in 2020 by Lambda Legal, Nichols Kaster, PLLP, and the Employment Law Center, PLLC, challenging West Virginia’s discriminatory exclusion of healthcare for transgender people in the State’s Medicaid program. 

“Accessing Medicaid coverage for gender-confirming care is vital to the livelihood and survival of myself and other transgender community members. West Virginia’s choice to appeal with the hope to deny us life-saving medical care is both demoralizing and shameful,” said plaintiff Shauntae Anderson.   

“All our plaintiffs request is to receive equal access to medically necessary care,” said Avatara Smith-Carrington, Staff Attorney at Lambda Legal and lead attorney on the case. “West Virginia’s decision to appeal the well-reasoned and legally sound ruling of the district court in order to be able to continue its discriminatory targeting of transgender West Virginia Medicaid participants is infuriating.”   

“I am outraged that West Virginia is wasting time and resources to appeal a court decision simply because our state would like to be allowed to discriminate against transgender West Virginians.” said plaintiff Christopher Fain.  

Lambda Legal, Nichols Kaster, PLLP, and the Employment Law Center, PLLC, filed the class action lawsuit, Fain v. Crouch, in 2020. In 2022, a settlement with The Health Plan of West Virginia, Inc. led to the removal of the exclusion on coverage for gender-confirming care in The Health Plan’s PEIA plans for state employees. On August 2, 2022 the district court ruled in favor of the Medicaid plaintiffs, finding that the exclusion violates the Fourteenth Amendment's Equal Protection Clause, the Affordable Care Act, and the Medicaid Act. 

Avatara Smith-Carrington, Tara Borelli, Carl Charles, Sasha Buchert, and Nora Huppert are handling the matter for Lambda Legal. They are joined by Anna Prakash and Nicole Schladt of Nichols Kaster, PLLP; and Walt Auvil of the Employment Law Center, PLLC.  

Read more about the case Fain v. Crouch:  

Read about the victory decision at the District Court:  


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