NC health plan resumes coverage of transgender surgeries

Jul 13, 2022, 4:00 AM | Updated: 4:03 pm

FILE - Lambda Legal lawyer Taylor Brown addresses reporters on March 11, 2019, in Durham, N.C., to ...

FILE - Lambda Legal lawyer Taylor Brown addresses reporters on March 11, 2019, in Durham, N.C., to announce a lawsuit arguing that North Carolina's health plan for state employees discriminates by not covering hormone treatment and surgery for transgender people. The state employee health plan will resume coverage of gender affirming treatments for transgender employees, the state treasurer said Wednesday, July 13, 2022, complying with a June federal court ruling that declared the refusal of coverage unconstitutional. (AP Photo/ Jonathan Drew, File)

(AP Photo/ Jonathan Drew, File)

RALEIGH, N.C. (AP) — The North Carolina state employee health plan will resume coverage of gender affirming treatments for transgender employees, the state treasurer said Wednesday, complying with a recent federal court ruling that declared the refusal of coverage unconstitutional.

State Treasurer Dale Folwell and the State Health Plan Board of Trustees agreed to reinstate coverage of “medically necessary services” — including hormone replacement therapy and surgeries — which the health plan had provided for a single year in 2017.

Folwell, calling the federal court ruling “legally incorrect,” said he is filing an appeal with the U.S. Court of Appeals for the Fourth Circuit. He said he would carry out the judge’s orders in the meantime.

“We obviously disagree with the judge’s order that is, in essence, assuming responsibility for determining plan benefits for sex transition operations,” Folwell said.

U.S. District Judge Loretta Biggs ruled in June that the state health plan unlawfully discriminates against transgender people, violating both the equal protection clause of the Constitution and Title VII of the Civil Rights Act on the basis of sex.

Overseen by Folwell’s office, the health plan provides medical coverage for more than 750,000 teachers, state employees, retirees, lawmakers and their dependents.

Several current and former state employees and their dependents had sued Folwell, the plan’s executive administrator, state universities and other government entities in 2019 for dropping coverage of medically necessary procedures once provided by the state.

Former State Treasurer Janet Cowell and the health plan board had voted in December 2016 not to enforce the plan’s exclusion of surgical and hormonal treatments for gender dysphoria for a single year. They estimated the annual cost for such coverage would be several hundred thousand dollars, according to the order. The coverage exclusion resumed under Folwell, a Republican, who took office in 2017.

Biggs wrote in her ruling that doctors, medical associations and the health plan’s third-party administrators agreed gender affirming procedures “can be medically necessary to treat gender dysphoria” in some cases.

“I’ve always said that if the legislature or the courts tell me we have to provide for sex transition operations and treatments, I would,” Folwell said, adding that he was disappointed the court did not bring the case before a jury.


Schoenbaum is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow her on Twitter at

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.



Associated Press

Body of avalanche victim in Washington state recovered after being spotted by volunteer

Search crews have recovered the body of a climber who was one of three killed in an avalanche on Washington's Colchuck Peak in February.

1 day ago

Eugene and Linda Lamie, of Homerville, Ga., sit by the grave of their son U.S. Army Sgt. Gene Lamie...

Associated Press

Biden on Memorial Day lauds generations of fallen US troops who ‘dared all and gave all’

President Joe Biden lauded the sacrifice of generations of U.S. troops who died fighting for their country as he marked Memorial Day with the traditional wreath-laying ceremony at Arlington National Cemetery.

2 days ago

OpenAI's CEO Sam Altman, the founder of ChatGPT and creator of OpenAI gestures while speaking at Un...

Associated Press

ChatGPT maker downplays fears they could leave Europe over AI rules

OpenAI CEO Sam Altman on Friday downplayed worries that the ChatGPT maker could exit the European Union

3 days ago

File - Alphabet CEO Sundar Pichai, left, and OpenAI CEO Sam Altman arrive to the White House for a ...

Associated Press

Regulators take aim at AI to protect consumers and workers

As concerns grow over increasingly powerful artificial intelligence systems like ChatGPT, the nation’s financial watchdog says it’s working to ensure that companies follow the law when they’re using AI.

5 days ago

FILE - A security surveillance camera is seen near the Microsoft office building in Beijing, July 2...

Associated Press

Microsoft: State-sponsored Chinese hackers could be laying groundwork for disruption

State-backed Chinese hackers have been targeting U.S. critical infrastructure and could be laying the technical groundwork for the potential disruption of critical communications between the U.S. and Asia during future crises, Microsoft said Wednesday.

6 days ago

FILE - President Joe Biden speaks in the East Room of the White House, May 17, 2023, in Washington....

Associated Press

White House unveils new efforts to guide federal research of AI

The White House on Tuesday announced new efforts to guide federally backed research on artificial intelligence

7 days ago

Sponsored Articles

Internet Washington...

Major Internet Upgrade and Expansion Planned This Year in Washington State

Comcast is investing $280 million this year to offer multi-gigabit Internet speeds to more than four million locations.

Compassion International...

Brock Huard and Friends Rally Around The Fight for First Campaign

Professional athletes are teaming up to prevent infant mortality and empower women at risk in communities facing severe poverty.

Emergency Preparedness...

Prepare for the next disaster at the Emergency Preparedness Conference

Being prepared before the next emergency arrives is key to preserving businesses and organizations of many kinds.

SHIBA volunteer...

Volunteer to help people understand their Medicare options!

If you’re retired or getting ready to retire and looking for new ways to stay active, becoming a SHIBA volunteer could be for you!

safety from crime...

As crime increases, our safety measures must too

It's easy to be accused of fearmongering regarding crime, but Seattle residents might have good reason to be concerned for their safety.

Comcast Ready for Business Fund...

Ilona Lohrey | President and CEO, GSBA

GSBA is closing the disparity gap with Ready for Business Fund

GSBA, Comcast, and other partners are working to address disparities in access to financial resources with the Ready for Business fund.

NC health plan resumes coverage of transgender surgeries