Iowa Supreme Court puts off decision on whether state must pay for transgender care

DES MOINES, Iowa (KCRG) – In dismissing an appeal from the Governor Reynolds Administration, the Iowa Supreme Court declined to decide whether Iowa Medicaid is required to cover gender reassignment surgeries.

A district court in 2021 ordered Iowa Medicaid to pay for needed gender surgeries for two Iowans. Since then, the Iowa Department of Human Services paid for the surgeries but appealed anyway. Because of that, the Iowa Supreme Court ruled the appeal is moot and the issue is “now merely of academic interest to these litigants”.

“We save the constitutional issues for another day, presumably with a better-developed record,” Justice Thomas Waterman writes in the opinion.

The constitutional issue in question is whether a state law passed in 2019 that specifically says governments are not required to pay for gender reassignment surgeries amounts to discrimination and violates equal protection guarantees in the Iowa Constitution. Because the surgery in this case is done and paid for, Iowa Supreme Court declined to issue a ruling on the issue.

That 2019 law arose out of an earlier lawsuit that found the state’s denial of transgender care services amounted to sex and gender discrimination under the Iowa Civil Rights Act.

The Iowa ACLU, which brought the lawsuit, gives a timeline of the issue on its website.

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