SLC and Co-Counsel Ask Eleventh Circuit Court of Appeals to Affirm Ruling Striking Down Anti-Transgender Medicaid Ban

NOVEMBER 27, 2023 (TALLAHASSEE, FL)

Today, Southern Legal Counsel (SLC), Lambda Legal, Florida Health Justice Project (FHJP), National Health Law Program (NHeLP), and the law firm Pillsbury Winthrop Shaw Pittman LLP urged the U.S. Court of Appeals for the Eleventh Circuit to affirm a lower court ruling that struck down Florida’s anti-transgender rule and statute that banned coverage for evidence-based, widely accepted gender-affirming medical care for all of the state’s transgender Medicaid beneficiaries.

Following a thorough two-week trial in June, U.S. District Court Judge Robert L. Hinkle ordered the Florida Agency for Health Care Administration (AHCA) to end enforcement of its discriminatory ban on gender-affirming medical care for transgender Medicaid beneficiaries, promulgated last August. The ruling also nullified the section of the transgender health care ban – SB  254 – recently enacted by the Florida legislature, that similarly banned state funding, including Medicaid coverage, for gender-affirming medical care. However, on June 27, Florida Gov. Ron DeSantis’s administration appealed that decision to the Eleventh Circuit.

The case under appeal is Dekker v. Weida, a federal lawsuit filed in September 2022 by Southern Legal Counsel, Lambda Legal, Florida Health Justice Project, the National Health Law Program, and Pillsbury Winthrop Shaw Pittman LLP on behalf of four plaintiffs: August Dekker (he/him) and Brit Rothstein (he/him), as well as two minors identified under pseudonyms Susan Doe (represented by her parents Jane and John Doe) and K.F. (represented by his mother, Jade Ladue).  

“As a transgender person whose health and life depend on access to gender-affirming care, I am extremely frustrated and disappointed to see the state of Florida appealing this decision. I feel like the state has no respect for our humanity and is doing all it can to target our health, our lives, our very existence.” said plaintiff Brit Rothstein. “I am certain that if most Floridians heard what we go through, they would understand how critical this medically necessary healthcare is and would oppose the state’s attempts to deprive us. If this decision is reversed, the health and wellbeing of transgender Floridians like myself would be at risk.” 

“The state’s appeal of the trial court’s scrupulous order is part of the broader multi-faceted attack on transgender individuals in the state of Florida, whose rights and freedoms have been eroded in myriad ways over the past two years,” said Simone Chriss, Director of the Transgender Rights Initiative at Southern Legal Counsel. “As the district court correctly held, the state’s decision to strip all transgender Florida Medicaid beneficiaries of access to evidence-based gender-affirming medical care was ‘an exercise in politics, not good medicine.’”

“Like everyone, transgender Floridians who are Medicaid beneficiaries deserve to have access to the health care that they need and have a right to be free from discrimination. After an extensive trial, a district court found that Florida’s decision to prohibit Medicaid coverage for gender-affirming medical treatment had no reasonable basis in law or fact. We agree with the district court and have asked the Eleventh Circuit to affirm the court’s detailed and well-reasoned decision.” said Omar Gonzalez-Pagan, Counsel and Health Care Strategist at Lambda Legal. 

“The Medicaid program is intended to ensure access to necessary health care for people most in need and those with the fewest resources,” said Abbi Coursolle, Senior Attorney at the National Health Law Program. “Judge Robert L. Hinkle’s ruling, which we hope the 11th Circuit upholds, confirmed that transgender Floridians enrolled in Medicaid have the right to access medically necessary gender-affirming health care.”

“Florida’s Medicaid program is there to provide medically necessary healthcare to all enrollees in the state,” said Katy DeBriere, Legal Director at FHJP. “In its 54-page decision, the district court recognized the state’s obligation to treat Floridians equally under the Medicaid Act and, given the district judge’s careful fact-finding and solid reasoning, the Eleventh Circuit should conclude the same.“

BACKGROUND

On August 21, 2022, AHCA, which oversees Florida’s Medicaid Program, adopted a discriminatory rule that denies Medicaid coverage for, and therefore access to, necessary and evidence-based medical care for thousands of transgender people in Florida, notwithstanding that this medical care was long covered by Florida Medicaid, and has been proven over decades to be safe and effective. 

On May 17, 2023, during the pendency of the trial in this case, Governor DeSantis signed SB 254 into law, which, among other things, prohibits the expenditure of state funds for the provision or coverage of gender-affirming care. The next day the case was amended to include a challenge to Section 3 of SB 254, using the same evidence developed at trial.   

In addition to striking down these provisions as unlawful, the district court relied in large part on the trial record developed in Dekker to halt temporarily enforcement of the Florida Board of Medicine’s ban on gender-affirming health care and related aspects of SB 254 in Doe. v. Ladapo, a similar lawsuit filed by Southern Legal Counsel, GLBTQ Legal Advocates & Defenders, the National Center for Lesbian Rights, and Human Rights Campaign.  

Read more about the case Dekker, et al. v. Weida, et al., here.