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Iowa Judge Rules State Can’t Ban Medicaid Coverage for Sex Reassignment Surgery

District Court Judge William P. Kelly ruled the state of Iowa's ban on Medicaid coverage of sex reassignment surgeries violates Iowa's Civil Rights Act and Constitution.

Shane Vander HartbyShane Vander Hart
November 23, 2021
in State Government
Reading Time: 3 mins read

Polk County Courthouse in Des Moines, Iowa.
Photo by Shane Vander Hart

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DES MOINES, Iowa – District Court Judge William P. Kelly on Friday ruled that the state’s ban on Medicaid dollars being used for sex reassignment surgery for Iowans to identify as transgender violates the Iowa Civil Rights Act and Iowa Constitution’s equal protection clause. The ruling was posted online on Monday.

The Iowa Legislature in 2019 passed a law, signed by Gov. Kim Reynolds, prohibiting taxpayer dollars under Medicaid from being used for sex reassignment surgeries after the Iowa Supreme Court ruled in 2019 in Good v. Iowa Department of Human Services that the agency could not prohibit Medicaid coverage for the procedure by administrative rule since 

After they were denied coverage for the procedure, the American Civil Liberties Union of Iowa (ACLU of Iowa) sued the Iowa Department of Human Services on behalf of Aiden Vasquez and Mika Covington, two Iowans diagnosed with gender dysphoria.

The Mayo Clinic defines gender dysphoria as “the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics.”

It is a diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

“Once the medical community determined that surgery is medically necessary to treat this health issue, the government lost its rational basis to refuse to pay for the surgery,” Kelly wrote in his ruling. 

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“The law appears to draw an arbitrary distinction. So, there is no plausible policy reason advanced by, or rationally related to, excluding transgender people from Medicaid reimbursement for medically necessary procedures,” he added. 

Rita Bettis Austen, legal director of the ACLU of Iowa, celebrated the ruling. 

“This is a historic win for civil rights in Iowa. It recognizes what we’ve long known, that transgender Iowans must not be discriminated against, and that they are protected by the Iowa Constitution’s guarantee of equal protection, as well as by the Iowa Civil Rights Act,” she said in a released statement.

Reynolds’ office said that they are reviewing the decision. 

“The governor’s office is disappointed in today’s decision and disagrees with the district court’s ruling on Medicaid coverage for transgender reassignment surgeries. We are reviewing the decision with our legal team and exploring all options moving forward,” Alex Murphy, Gov. Reynolds’ spokesperson, said in a statement. 

The FAMiLY Leader blasted the decision in a Facebook post on Monday and encouraged the governor to appeal the ruling. 

“Last Friday, an Iowa judge unilaterally added a new ‘right’ to the Iowa Constitution: the right to government-funded sex-change surgery. This ruling is a gross violation of the right of self-government and a tortuous manipulation of the Iowa Constitution. Gender dysphoria is a serious condition that requires compassionate expression of the truth that men and women are created specially unique. Invasive (and ineffective) surgery and social experimentation are not substitutes for a compassionate expression of the truth,” they wrote.

“The governor should appeal and the Iowa Supreme Court should correct this errant decision. In the meantime, the Iowa Legislature should remove the sexual orientation and gender identity language from the Civil Rights Code, which is being used by courts to manipulate and subvert our state constitution,” the social conservative organization added.

The Iowa Legislature added sexual orientation and gender identity to protected classes listed in Iowa’s Civil Rights Act in 2007.

Read the ruling below:

Covington v Iowa DHS Iowa District Court Ruling
Tags: ACLU of IowaAiden VasquezIowa Civil Rights ActIowa ConstitutionIowa District CourtKim ReynoldsMedicaidMika CovingtonRita Bettis AustenThe FAMiLY Leadertransgender issuesWilliam Kelly
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Shane Vander Hart

Shane Vander Hart

Shane Vander Hart is the editor of The Iowa Torch.

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