Attorney General Becerra Leads Coalition in Support of Healthcare Rights for Transgender Americans

Wednesday, October 7, 2020
Contact: (916) 210-6000,

SACRAMENTO — California Attorney General Xavier Becerra today led a coalition of 17 states and the District of Columbia in filing an amicus brief supporting the plaintiffs in Kadel v. N.C. State Health Plan. The plaintiffs, Maxwell Kadel, Jason Fleck, Connor Thonen-Fleck, Julia McKeown, Michael D. Bunting, Jr., C.B., and Sam Silvaine, all state employees and their families, sued the North Carolina State Health Plan for denying health coverage. Specifically, the plaintiffs seek coverage for gender dysphoria or other gender-affirming treatment, arguing that Section 1557 of the Affordable Care Act (ACA) protects transgender individuals from discrimination in healthcare and requires the State to provide them with coverage.

“All people should have access to healthcare, period. This includes transgender individuals who have a right to live their lives with dignity, free from discrimination,” said Attorney General Becerra. “Here in California, we have laws that protect transgender Americans from discrimination in accessing state services and benefits, including healthcare. We’ve seen the positive outcome that ensuring equality brings to our communities. We will continue to fight for equality for all transgender Americans.”

The ACA provides millions of Americans with access to quality, affordable health insurance coverage. It also prevents discrimination in healthcare through Section 1557, which extends prohibitions on sex discrimination to healthcare programs and services. Section 1557 expressly prohibits health programs and activities receiving federal financial assistance, including medical providers, health systems, and health insurers, from discriminating against individuals on the basis of race, color, national origin, sex, age, or disability.

In today’s brief, the coalition argues that by denying transgender individuals coverage for gender-affirming treatment and gender dysphoria, the North Carolina State Health Plan violated Section 1557’s anti-discrimination mandate. Systematic and widespread discrimination against transgender people in healthcare is what Section 1557 aims to prevent and combat. Instead, the Health Plan’s discriminatory tactics put the lives of transgender people at risk by denying them treatment known to improve their physical and mental health. The brief also argues that Section 1557 should be applied uniformly across the country in order to protect Americans from discrimination as Congress intended. The ACA’s reforms, along with state laws like California’s, which prohibit health insurers from excluding coverage for transgender health services, have significantly increased access to healthcare for LGBTQ+ individuals and their families. Allowing the North Carolina State Health Plan to selectively deny coverage to certain disadvantaged groups, like transgender people, causes uncertainty and confusion for people who are already reluctant to seek medical care. Applying Section 1557 uniformly will give all transgender Americans confidence that they will receive quality healthcare no matter where they are.

Attorney General Becerra is committed to protecting and upholding Section 1557 of the ACA and defending the rights of transgender individuals. Last month, the Attorney General joined a coalition of 23 attorneys general in a comment letter condemning a proposed rule by the Trump Administration that would allow discrimination against transgender Americans seeking shelter. In June, the Attorney General restricted state-funded travel to Idaho as a result of two discriminatory bills signed into law in the state that authorize discrimination against the transgender community. In December, Attorney General Becerra, Massachusetts Attorney General Maura Healey, and Pennsylvania Attorney General Josh Shapiro led a coalition of 19 attorneys general in filing a comment letter blasting the Trump Administration’s effort to undermine the healthcare rights of LGBTQ+ individuals and families. In July, Attorney General Becerra, Attorney General Healey, and New York Attorney General Letitia James, led a coalition in filing a lawsuit in the U.S. District Court for the Southern District of New York challenging the Trump Administration’s discriminatory rule undermining Section 1557 of the ACA. 

In filing the amicus brief, Attorney General Becerra was joined by the attorneys general of Colorado, Delaware, Hawaii, Illinois, Maine, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, Wisconsin, and the District of Columbia.

A copy of the amicus brief is available here.


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