Trans people in Iowa can now use Medicaid to pay for their transition-related surgeries.
In a unanimous decision handed down on Friday, the Supreme Court of Iowa ruled that trans people in the state can pay for gender-affirming surgeries using Medicaid funds, The Des Moines Register reports.
The ruling overturns the state's previously held administrative code regarding Medicaid, a federal and state program that offers low to no cost health insurance to lower-income people covering one in seven adults in the United States. The previous code deemed all trans-related surgeries "cosmetic, reconstructive, or plastic surgery" and not "medically necessary" enough to deserve such coverage. The justices found that exemption to be discriminatory under the state's Civil Rights Act -- a first, says a member of the American Civil Liberties Union, which argued the case on behalf of EerieAnna Good and Carol Beal.
With the ruling, Iowa joins a handful of other states and districts that explicitly cover transition-related surgeries -- though some of them, like New York and California, will only cover those deemed "medically necessary" by their insurer, as opposed to procedures like facial feminization surgery, which is often dismissed as purely cosmetic. Such a distinction does not appear to be present in the Iowa court's ruling, says John Knight of the ACLU's LGBT & HIV Project, leading him to believe that trans people in Iowa might be able to use Medicaid funds to pay for truly any transition-related surgery.
"The ruling is that the department that administers Medicaid can't exclude something from coverage because it's for transgender people," Knight tells Out. "So, I think that would mean any necessary surgery in the judgement of someone's medical provider should be provided for. [The Iowa Supreme Court] did not establish any rules about what would or would not be covered. We believe that there is no limitation created by this ruling."