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Trial ends in lawsuit over Florida's ban on Medicaid coverage for gender-affirming care

 Judge's gavel
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Attorneys for the plaintiffs say they're being denied access to medically necessary treatments. They expect the judge will rule on this case and another suit challenging the state's ban on gender-affirming care for minors at the same time.

Transgender Floridians suing the state over its ban on Medicaid coverage for gender-affirming medical care now await a federal judge’s ruling.

Arguments in the trial, which began earlier this month, wrapped up on Monday, just days after Gov. Ron DeSantis signed a law further restricting access to transgender health care in the state.

Plaintiffs in the case are two transgender adults named August Dekker and Brit Rothstein, along with two trans minors and their parents.

"These are folks who are on Medicaid because they are low income or disabled and they cannot otherwise afford access to their treatments that they need,” said Simone Chriss, director of Transgender Rights Initiative with Southern Legal Counsel, one of the groups representing the plaintiffs.

Advocates had eight expert witnesses, including psychologists, clinical researchers and health policy experts, among others, testify about the merits of gender-affirming care during the trial, according to Carl Charles, senior attorney with Lambda Legal.

They argued that puberty blockers, hormone therapy and certain surgeries are safe and effective in treating gender dysphoria, which is the medical term for a distress a person feels when their body does not align with their identity.

“The message is clear: this care saves people’s lives,” said Charles.

Attorneys with the Agency for Health Care Administration, which issued the rule prohibiting Medicaid reimbursements to health workers who provide these treatments last August, justified the ban. They argued the treatments are experimental and that the state is reasonable in stopping its Medicaid program from covering them.

Plaintiffs, including some whose Medicaid benefits had previously paid for their gender-affirming care, shared their stories during testimony as well.

Brit Rothstein, 20, received hormone therapy through his Medicaid coverage, and had been pre-authorized for chest surgery before the rule went into effect. After learning Medicaid would no longer cover that surgery, Rothstein had to rely on GoFundMe donations to pay for it, said Chriss.

“Not everyone will have that ability to do so and honestly they shouldn’t have to,” she said. “They’re entitled to Medicaid coverage and they’re entitled to the same aspects of care as their cisgender peers, and so for folks to have to go through these hoops and to have to beg other people for money in order to cover their medically-necessary treatment is just, it’s devastating.”

The lawsuit was amended to also challenge a provision in SB 254, the legislation Gov. DeSantis signed last week, which codifies the Medicaid ban into law and bars the use of other state funds to cover gender-affirming treatments.

There’s no set timeline for when U.S. District Judge Robert Hinkle will rule on the case, but Charles expects a decision to come soon.

“It was clear to us today the court had a sense of the urgency and the harm that is facing not just our clients and transgender Medicaid beneficiaries in the state of Florida, but now, the scope of SB 254 being as wide as it is, more transgender people broadly,” he said.

Another lawsuit is underway challenging rules that state medical boards implemented in March barring doctors from providing gender-affirming care to minors. Lawyers adjusted that suit to cover other provisions of SB 254, which strengthen those rules and make it harder for adults to access care as well.

Last week, Southern Legal Counsel was among the groups that filed a motion for Hinkle to issue a temporary restraining order blocking enforcement of that law while the case continues.

Chriss said Hinkle indicated he will rule on that order and issue a decision on the Medicaid case at the same time.

I cover health care for WUSF and the statewide journalism collaborative Health News Florida. I’m passionate about highlighting community efforts to improve the quality of care in our state and make it more accessible to all Floridians. I’m also committed to holding those in power accountable when they fail to prioritize the health needs of the people they serve.