W.Va. Gender-Affirming Surgery Case Kicked Back To Lower Court

The U.S. Supreme Court Monday overruled a lower court decision that required West Virginia to cover gender-affirming surgeries under Medicaid.

The Supreme Court vacated a decision by the Fourth U.S. Circuit Court of Appeals last year that the state’s exclusion of gender-affirming surgery under Medicaid violated federal law. 

Gov. Patrick Morrisey, then attorney general, appealed the Fourth Circuit’s ruling to the Supreme Court last year.

The case originated in 2020, when transgender adults covered by Medicaid and the state Public Employees Insurance Agency (PEIA) sued what was then the Department of Health and Human Resources (DHHR) and its secretary at the time, Bill Crouch.

U.S. District Judge Robert Chambers ruled against DHHR and Crouch in 2022. Morrisey then appealed to the Fourth Circuit, which voted last year 8-6 to affirm Chambers’ ruling.

The Supreme Court sent the case back to the Fourth Circuit, in Richmond, Virginia, to reconsider it in light of the recent Skrmetti decision, in which the Supreme Court upheld Tennessee’s ban on gender-affirming care for minors.

The Fourth Circuit ruling also applied to North Carolina’s health insurance program for state employees.