RALEIGH, N.C. — On Friday, U.S. District Judge Loretta Biggs ruled that North Carolina must cover gender-affirming health care for people who have state employee health insurance coverage.

What You Need To Know

The lawsuit, Kadel v. Folwell, was filed in 2019 on behalf of several current and former state employees and their dependents

The plaintiffs had the state employee health plan and were denied coverage for their medically necessary gender-affirming care

On Friday, a federal judge ruled that N.C. must cover gender-affirming health care for people who have state health insurance coverage

North Carolina still has the opportunity to appeal this decision

The lawsuit, Kadel v. Folwell, was filed in 2019 on behalf of several current and former state employees and their dependents. The plaintiffs had the state employee health plan and were denied coverage for their medically necessary gender-affirming care.

This ruling means state employees and their dependents will have coverage for health care associated with gender transition, including counseling, hormone therapy, surgery and more.

Due to a nondiscrimination rule in the Affordable Care Act, the state’s health insurance plan did cover gender-affirming care in 2017 and possibly even before then, but that coverage expired in 2018.

The ruling found the state’s exclusion of gender-affirming health care violates the equal protection clause of the Constitution and Title VII of the Civil Rights Act on the basis of sex.

Carl Charles is a senior attorney with Lambda Legal, the law firm that represented the plaintiffs, and Charles says this is a historic ruling.

“It is a victory not just for state employees who are transgender or state employees whose dependents are transgender. It is a victory for all supporters of equality and fairness within North Carolina,” Charles said. “It sends a really clear message to all transgender people who live in North Carolina, make their lives there, raise families there, that this a place where transgender people are welcome and where they can count on receiving the same kinds of health care benefits if they’re state employees as other people.”

The state health plan is overseen by State Treasurer Dale Folwell’s office. Folwell had hoped, before the judge ruled, that there would a be jury trial about whether taxpayers should be paying for “sexual transition operations.” Plan revenue includes state funds and premiums.

North Carolina still has the opportunity to appeal this decision. Charles says attorneys are still figuring out how this ruling applies to the plaintiff’s claims under the Affordable Care Act, as well as any potential monetary damages.

Moving forward, Charles says attorneys will also be working to make sure people have the coverage promised under this ruling.