The University of Arizona’s board of regents joins two state Department of Administration officials and the state itself as defendants in a professor’s lawsuit that claims Arizona’s employee healthcare plan unlawfully denies transgender members coverage for transition-related procedures. Filed by the American Civil Liberties Union Foundation and ACLU Foundation of Arizona, the suit seeks declaratory and injunctive relief that would provide healthcare plan members with the opportunity to have their transition-related claims evaluated under the same standards as other medical treatments under the state’s employee healthcare plan.
According to the proposed class action, the plaintiff, a transgender man, was denied coverage for a prescribed hysterectomy in August 2018 based solely on his healthcare plan’s “categorical ban” on gender reassignment surgeries. The suit explains that the plan covers all procedures that are deemed medically necessary yet “singles out” transgender members by denying all claims related to gender reassignment, regardless of whether the procedure meets the plan’s usual standards for required treatment. The lawsuit says the defendants’ alleged discrimination against transgender University of Arizona employees violates the Civil Rights Act of 1964, as well as the 14th Amendment’s Equal Protection Clause.
Although healthcare plan members typically reserve the right to appeal any denial of coverage to a third-party claims administrator, the complaint alleges that individuals who require gender reassignment surgeries are discriminated against in that they “have no opportunity to demonstrate that their transition-related care is medically necessary,” nor the option to appeal any decision.
The suit points out that while the plan’s four network providers—Aetna, Blue Cross Blue Shield of Arizona, Cigna and UnitedHealthcare—have their own protocols for determining when transition-related care is medically necessary, the plan’s outright exclusion of coverage automatically denies the companies the opportunity to evaluate plan members’ claims. According to the lawsuit, the defendants’ seemingly illogical ban on procedures that would otherwise be covered absent gender reassignment purposes is rooted in discrimination.
“The Plan’s discriminatory exclusion lacks any rational basis and is grounded in sex stereotypes, discomfort with gender nonconformity and gender transition, and moral disapproval of people who are transgender,” the case argues.