Georgia agrees to pay for gender-affirming care for public employees, settling a lawsuit

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The December lawsuit argued the insurance plan illegally discriminated by refusing to pay for transition-related care.

ATLANTA — The state of Georgia will start paying for gender-affirming health care for state employees, public school teachers and former employees covered by a state health insurance plan, settling another in a string of lawsuits against Georgia agencies aiming to force them to pay for gender-confirmation surgery and other procedures.

The plaintiffs moved to dismiss their case Thursday in Atlanta federal court, announcing they had reached a settlement with the State Health Benefit Plan.

The December lawsuit argued the insurance plan illegally discriminated by refusing to pay for gender-affirming care.

“There’s no justification, morally, medically, legally or in any other way for treating transgender healthcare as different and denying people access to it,” David Brown, a lawyer for the plaintiffs, said in a phone interview Thursday.

The state Department of Community Health, which oversees the insurance plan, did not immediately respond Thursday to an email seeking comment.

Benjamin Johnson.
Benjamin Johnson.Transgender Legal Defense & Education Fund

The state will also pay a total of $365,000 to the plaintiffs and their lawyers as part of the settlement. Micha Rich, Benjamin Johnson and an anonymous state employee suing on behalf of her adult child all said they spent money out of their own pockets that should have been covered by insurance.

Starting July 1, Georgia legally barred new patients under the age of 18 from starting hormone therapy and banned most gender-affirming surgeries for transgender people under 18. That law, challenged in court but still in effect, lets doctors prescribe puberty-blocking medications and allows minors already receiving hormone therapy to continue.

But Brown said Thursday’s settlement requires the health plan to pay for care deemed medically necessary for spouses and dependents as well as employees. That means the health plan could be required to pay for care for minors outside the state even though it’s prohibited in Georgia.

“The plan can’t treat the care any differently from other care that’s not available in the state,” Brown said.

The lawsuit cited a 2020 Supreme Court ruling that treating someone differently because they are transgender or gay violates a section of the Civil Rights Act of 1964 prohibiting discrimination on the basis of sex. The plaintiffs in that case included an employee of Georgia’s Clayton County.

Micha Rich
Micha Rich.Transgender Legal Defense & Education Fund

Affected are two health plans paid for by the state but administered by Anthem Blue Cross and Blue Shield and UnitedHealthcare.

It’s the fourth in a line of lawsuits against Georgia agencies to force them to pay for gender-confirmation surgery and other procedures. State and local governments lost or settled the previous suits.

The University System of Georgia paid $100,000 in damages in addition to changing its rules in 2019 when it settled a case brought by a University of Georgia catering manager. And the Department of Community Health last year agreed to change the rules of the state’s Medicaid program to settle a lawsuit by two Medicaid beneficiaries.

A jury last year ordered Houston County to pay $60,000 in damages to a sheriff’s deputy after a federal judge ruled her bosses illegally denied the deputy health coverage for gender-confirmation surgery. Houston County is appealing that judgment, and oral arguments are scheduled in November before the 11th U.S. Circuit Court of Appeals.

The plaintiffs in the lawsuit settled Thursday included three transgender men. Micha Rich is a staff accountant at the Georgia Department of Audits and Accounts, and Benjamin Johnson is a media clerk with the Bibb County School District in Macon. The mother of the third man, identified only as John Doe, is a Division of Family and Children Services worker in Paulding County and covers the college student on her insurance.

All three were assigned female at birth but transitioned after therapy. All three appealed their denials for top surgery to reduce or remove breasts and won findings from the U.S. Equal Employment Opportunity Commission that Georgia was discriminating against them.

“I am thrilled to know that none of my trans colleagues will ever have to go through what I did,” Rich said in a statement.

A court ruling found a similar ban in North Carolina to be illegal; the state is appealing. A Wisconsin ban was overturned in 2018. West Virginia and Iowa have also lost lawsuits over employee coverage, while Florida and Arizona are being sued.

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