Florida banned Medicaid from paying for gender-affirming care. (Photo illustration via Canva)
Nearly 17 months after a federal judge struck down Florida’s ban on Medicaid reimbursements for gender-affirming care, the case is going to be heard by a federal appeals court.
The U.S. Court of Appeals for the Eleventh Circuit will hold oral arguments on Nov. 22 in Atlanta before a panel of three judges — Barbara Lagoa, Kevin Newsom, and Jill Pryor. Lagoa, who once served on the Florida Supreme Court, and Newsom were appointed by former President Donald Trump while Pryor was appointed by former President Barack Obama.
U.S. District Judge Robert Hinkle in June 2023 ruled against both a rule and a state law that barred Medicaid dollars being spent on care such as puberty blockers and cross-sex hormones as treatment for gender dysphoria. The lawsuit was brought against the state by a coalition of groups including Lambda Legal, Southern Legal Counsel, and Florida Health Project on behalf of four transgender people, two of whom are adolescents.
The lawsuit contended the ban was unconstitutional and also violated federal health care laws including the Affordable Care Act. They pointed out Florida had previously been covering certain types of gender-affirming care.
Complying with Medicaid requirements
The case has attracted widespread attention from other states and an array of groups as well as the federal government. Even though Trump has won back the White House, attorneys representing the U.S. Department of Justice Civil Rights Division and the U.S. Department of Health & Human Services asked in late October to present arguments at next week’s court hearing on behalf of those who sued Florida.
“The United States has a strong interest in states compliance with Medicaid’s requirements,” stated the Oct. 31 request, which the court granted. “The United States believes that its participation at argument will be helpful in this court in correctly applying the requirements of the Medicaid statute.”
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In its November 2023 brief in the appeal, lawyers representing those who sued Florida wrote that “these measures constitute a clear expression of governmental hostility toward transgender Floridians and establish an official policy of disapproval, with the goal of preventing transgender Floridians from participating openly or equally in civil society. No other state has enacted as many anti-transgender measures as Florida.”
The state, in its initial brief filed in October 2023, contended there was not overwhelming evidence in favor of types of gender-affirming care and it should be up to Florida to decide whether Medicaid covers the treatments.
“It’s a health and welfare question, it’s a medical policy issue. It’s an area where the state gets to draw the line between what’s permissible and what isn’t,” said attorneys representing the Agency for Health Care Administration.
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