Trial starts on Medicaid trans care
By Jim Saunders
News Service of Florida
May 9, 2023
TALLAHASSEE — Amid a series of legal and political battles in Florida about transgender people, a federal judge Tuesday heard opening arguments in a challenge to a state decision to prevent Medicaid coverage for treatments such as puberty blockers and hormone therapy.
Omar Gonzalez-Pagan, an attorney for plaintiffs challenging the decision, told U.S. District Judge Robert Hinkle that such treatments for gender dysphoria are backed by major medical associations and research. He said the state disregarded evidence in approving the ban.
“The defendants are not concerned with the evidence, but rather their goal of not covering the safe and effective care,” said Gonzalez-Pagan, an attorney with Lambda Legal, a national LGBTQ-rights group.
But during a brief opening argument, Mohammad Jazil, an attorney for the Florida Agency for Health Care Administration, indicated the state will argue that the treatments are experimental and that the state’s position is reasonable and rational.
Transgender plaintiffs filed the lawsuit in September after the Agency for Health Care Administration, which runs most of the Medicaid program, finalized a rule preventing Medicaid reimbursements to health-care providers for puberty blockers, hormone therapy and certain surgical procedures to treat gender dysphoria. The federal government defines gender dysphoria clinically as “significant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.”
The agency’s decision came amid a broader focus by Gov. Ron DeSantis’ administration, the Republican-controlled Legislature and GOP leaders across the country to target transgender issues.
As an example, Florida lawmakers last week passed a DeSantis-backed bill that would bar doctors from providing treatments such as puberty blockers and hormone therapy to minors. That bill would essentially would put into law rules adopted by state medical boards to prevent such treatments for minors. The decisions by the Board of Medicine and the Board of Osteopathic Medicine also have drawn a federal-court challenge.
The lawsuit over the Medicaid rule was filed on behalf of two transgender adults and two transgender minors, along with parents of the minors. It contends, in part, that medical care for the treatment of gender dysphoria is “medically necessary, safe and effective” for transgender adolescents and adults.
Also, the lawsuit contends that denial of reimbursements for treating transgender people is discriminatory because the same health-care services are “routinely covered by Medicaid when they are for medically necessary purposes other than the treatment of gender dysphoria.”
The lawsuit alleges that the state’s decision violated constitutional equal-protection rights, the Affordable Care Act and a Medicaid law.
While Jazil only made a brief opening argument Tuesday, Gonzalez-Pagan gave a broader overview of the plaintiffs’ arguments. That included indicating the plaintiffs will challenge the credentials of experts used by the Agency for Health Care Administration in developing the rule. He also disputed that the treatments are experimental.