Lambda Legal Adds Two Additional Transgender Plaintiffs to its Challenge to West Virginia’s Unlawful Ban On Health Care Coverage

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September 23, 2021

Today, Lambda Legal filed a motion seeking leave to add two additional plaintiffs—a Medicaid participant and a public employee—to its federal class-action lawsuit challenging West Virginia's blanket exclusion of health care coverage for transgender people in West Virginia's Medicaid and state employee health plans.

If granted, Shauntae Anderson, who is a Medicaid participant, and Leanne James, a public employee and Public Employee Insurance Agency (PEIA) member would be added as additional plaintiffs to Fain v. Crouch.

"My life as a Black transgender woman has not been easy. I suffered years of agony and desperation without appropriate care and treatment for my gender dysphoria. Like other Medicaid participants, I rely on Medicaid for health care coverage and it has been heartbreaking to hear that just because I am transgender, I can’t access coverage for care that is medically necessary. It is not only inhumane but also unjust to be singled out this way," said plaintiff Shauntae Anderson.  

“It is deeply upsetting that I am deprived of coverage for critical and urgent health care simply because I am transgender. As a public employee and PEIA member, being denied coverage for medically necessary care that cisgender state employees have full access to is an insult to my dignity. The exclusion in the state employee health plans is a reminder to myself and other transgender state employees that we are being denied equal compensation for equal work.” said plaintiff Leanne James.

Filed last November in West Virginia's Southern District, Fain v. Crouch is a class action lawsuit challenging blanket exclusions of coverage for gender-confirming care in West Virginia state health plans. The blanket exclusions of coverage for care are stated expressly in the health plans offered to Medicaid participants and state employees. West Virginia's state health plans serve approximately 564,000 Medicaid participants and 15,000 state employees, some of whom are transgender. 

"The state of West Virginia continues to deny medically necessary gender-confirming health care to transgender West Virginians – via explicit and targeted exclusions. West Virginia’s ban on gender-confirming care is unconstitutional and discriminatory; it causes physical, emotional, and financial distress; and it denies transgender West Virginians basic dignity, equality, and respect. Ms. Anderson and Ms. James are just two of many transgender people in West Virginia who are being denied basic health care just because of who they are." said Avatara Smith-Carrington, Staff Attorney at Lambda Legal and lead attorney on the case.

“We admire Ms. Anderson and Ms. James for stepping forward and joining our original plaintiffs in this lawsuit,” said Nicole Schladt, Associate Attorney at Nichols Kaster, PLLP. “Together, we seek an end to healthcare discrimination in West Virginia.”

BACKGROUND 

Lambda Legal has filed similar challenges in other states with blanket exclusions of coverage for gender-confirming care in state employee health plans. In March 2020, Lambda Legal secured a victory for an Alaska state librarian denied coverage for her gender-confirming care. Also, that month, a U.S. district court judge rejected 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. And as recently as this month, the Fourth Circuit, which includes West Virginia, ruled that a state—North Carolina— was not exempt from being sued for discrimination on healthcare under Section 1557 of the Affordable Care Act as the state health plan is the recipient of federal funds. 

New plaintiffs: 

Shauntae Anderson is a 45-year-old Black transgender woman born and raised in West Virginia. For years, Shauntae has advocated for gender-confirming care for transgender people, including while previously incarcerated. Shauntae works in a warehouse as a Wrapper Operator and barely makes ends meet on her salary, which makes the denial of coverage for gender-confirming care a significant hardship.

Leanne James is a 43-years-old transgender woman born and raised in West Virginia. As a public employee, Leanne is eligible for and enrolled in a PEIA health plan offered by the state. 

Original Plaintiffs: 

Christopher Fain is an adjunct professor at Mountwest Community and Technical College. He is a Medicaid participant. Medicaid is the nation's largest healthcare provider for low-income individuals. Christopher urgently requires chest reconstruction surgery, but is barred from receiving this care by the discriminatory exclusion in West Virginia’s Medicaid plan.

Zachary Martell is married to Brian McNemar, who works as an accountant at a state hospital. Both Zachary and Brian rely on the state employee health plan for coverage. Zachary is Brian's dependent. Zachary has been denied coverage both for his prescriptions and office visits with his health care provider because the state employee health plans explicitly exclude "treatments associated with gender dysphoria." As a result, Zachary and Brian pay out-of-pocket for Zachary's care and, at times, have had to delay or forego care altogether.

Lawyers:

Avatara Smith-Carrington, Tara Borelli, Sasha Buchert, Nora Huppert, and Carl Charles are handling the matter for Lambda Legal. The co-counsel is Anna Prakash and Nicole Schladt of Nichols Kaster PLLP and Walt Auvil of the Employment Law Center, PLLC.

Learn more about the case: https://www.lambdalegal.org/in-court/cases/fain-v-crouch

Read the original complaint: https://www.lambdalegal.org/in-court/legal-docs/fain_wv_20201112_complaint

Read the amended complaint: https://www.lambdalegal.org/in-court/legal-docs/fain_wv_20210923_amended-motion-to-file-first-amended-complaint

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Contact Info

Samy Nemir snemir@lambdalegal.org, (202) 672-4877

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