State officials want a federal judge to dismiss a lawsuit filed on behalf of a Delaware County transgender man who seeks Medicaid coverage for a hysterectomy.
In a March 31 pleading, state officials claimed the suit lacks merit and urged U.S. District Judge J. Curtis Joyner to dismiss it.
“John Doe” is diagnosed with gender dysphoria and seeks Medicaid coverage for a medically necessary hysterectomy, according to a lawsuit filed in February.
But state health officials refuse to cover the procedure, noting that according to state regulations, treatments for gender dysphoria aren’t covered in the state’s Medicaid program.
The named defendant in Doe’s suit is Theodore Dallas, secretary of the state’s Department of Human Services.
In his 17-page pleading, Dallas said the state’s Medicaid program doesn’t cover many procedures prescribed by physicians due to limited funds.
“[M]any other safe, effective and warranted services are not covered in the Pennsylvania [Medicaid] Program, or other state programs, although such services may be prescribed by an individual’s treating physician as needed by the individual,” Dallas asserted. “In the absence of a federal requirement, state policy makers, as stewards of the public fisc, must make difficult decisions in the allocation of limited resources, even when their own personal preferences would be to allow coverage for particular services or treatment for some or all individuals.”
Dallas acknowledged that Pennsylvania receives some federal funding to support its Medicaid program. But he claimed the federal Affordable Care Act doesn’t mandate coverage for gender-dysphoria treatments.
Moreover, the act doesn’t preclude discrimination on the basis of gender identity and expression, or the failure to conform to the sex and gender stereotypes associated with one’s anatomical sex, according to Dallas’ filing.
State officials had no comment for this story.
In a prior statement, Gov. Tom Wolf indicated his support for Medicaid coverage for gender-dysphoria treatments. But Wolf also said he “hope[s] to have a robust conversation with the [state] legislature, community and all other parties regarding this issue to move the commonwealth forward.”
Julie Chovanes, an attorney for Doe, expressed optimism that Pennsylvania eventually will cover gender-dysphoria treatments in its Medicaid program.
“I’m optimistic that it’s simply a matter of time before the state regulations are found to be in violation of federal law,” Chovanes said. “Until that happens, we’ll proceed ahead.”
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