Georgia's health insurance for state employees now covers transition-related care under a settlement reached in a lawsuit by the Transgender Legal Defense and Education Fund.
The agreement announced Thursday comes as open enrollment continues, TLDEF noted in a news release.
TLDEF and co-counsel Bondurant Mixson & Ellmore filed the lawsuit last December on behalf of three public employees and the child of one, as well as the Campaign for Southern Equality. The motion, filed in the U.S. District Court for the Northern District of Georgia, argued that the exclusion of gender-affirming procedures under the Georgia State Health Benefit Plan constituted unlawful discrimination. The plan covers more than half a million Georgians, including employees of state agencies and public school districts and their family members.
As part of the settlement, those insured under the plan will be able to immediately access transitional procedures. All insurance options offered by the state plan contain this provision: “Transgender health insurance coverage generally includes medically necessary transgender surgeries and/or other services deemed medically necessary and by the member's treating medical personnel in accordance with the Standards of Care of the World The Professional Association for Transgender Health, also known as WPATH, has included treatment of gender dysphoria in its standards of care, as discussed below [the third-party administrator’s] medical guidelines.”
Additionally, the state will pay monetary damages totaling $365,000 to the plaintiffs in this case: Micha Rich, Benjamin Johnson and Jane Doe, who are employees of Georgia government agencies and who were denied transgender-related health care; John Doe, Jane Doe's young adult child enrolled in SHBP through his mother; and the Campaign for Southern Equality, a nonprofit organization dedicated to advancing LGBTQ+ civil rights throughout the South. The settlement also covers a portion of her legal costs.
Additionally, Anthem-operated plans remove the exclusion for “gender reassignment and/or sex reversal services and supplies,” and United-operated plans remove the exclusion for “sex change surgeries and related services.” And the state is prohibited from creating a similar exclusion again.
“I am thrilled to know that none of my transgender colleagues will ever have to go through what I did,” Rich, an accountant with the Georgia Department of Audits and Accounts, said in the release. “I hope this is a new day for my beloved state of Georgia in its treatment of trans and non-binary people.”
“In a year where transphobic extremists have pushed one restriction after another on transgender people's access to necessary health care, a development like this that allows transgender Georgians easier access to health care is a major victory,” added Added Holiday Simmons, Director of Healing and Resilience for the Campaign for Equality in the South. “No government should interfere with residents’ private medical decisions, and we are encouraged to see that transgender people who are Georgia state employees will no longer be denied coverage for life-affirming and even life-saving health care.”
This settlement follows a June 2022 victory in the TLDEF lawsuit Lange v. Houston County, in which a federal court in Georgia ruled that an employer cannot exclude or deny coverage of transition-related medical treatments from its employees' health insurance. It was the first such verdict in the South. Earlier this year, the state of Georgia also ended the exclusion of transgender-related health care in its Medicaid plan following a federal case called Thomas v. Georgia Department of Community Health had been sued. And in 2018, the University System of Georgia filed a lawsuit, Musgrove v. Board of Regents settled case brought by TLDEF's former head of Trans Health Project, in which it agreed to remove the exclusion of trans health care from its employee health plan and pay plaintiff $100,000. Employers across the country have lost or settled dozens of similar lawsuits in recent years.
Pictured from left: Benjamin Johnson and Micha Rich