Fain v. Crouch

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Status: Open
Court:
U.S. District Court for the Southern District of West Virginia
Issues: Health Care Fairness, Transgender Rights

Lambda Legal filed a federal lawsuit challenging West Virginia’s blanket exclusions of coverage for gender-confirming care in its Medicaid and state employee health insurance plans.

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The class-action lawsuit was filed in the U.S. District Court for the Southern District of West Virginia on behalf of Christopher Fain, a Medicaid participant; and Zachary Martell and Brian McNemar, a dependent and state employee, respectively.

The suit challenges blanket exclusions of coverage for gender-confirming care in West Virginia’s state health plans. The blanket exclusions of coverage for care are stated expressly in the health plans offered to Medicaid participants and to state employees. West Virginia’s state health plans serve approximately 564,000 Medicaid participants and 15,000 state employees.

The lawsuit added Shauntae Anderson, who is a Medicaid participant, and Leanne James, a public employee and Public Employee Insurance Agency (PEIA) member, in Fall 2021.

Lambda Legal has filed similar lawsuits against other states that include blanket exclusions for gender-confirming in state employee health plans. In March, Lambda Legal secured a victory for an Alaska state librarian denied coverage for her gender-confirming care. Also, in March, a U.S. district court judge denied an effort by the state of North Carolina to dismiss a lawsuit filed by Lambda Legal on behalf of North Carolina state employees and their dependents denied coverage for gender-confirming care.