By HANNAH SCHOENBAUM


North Carolina’s state employee health plan will resume offering gay-affirmation benefits to transgender employees, the state’s treasurer said Wednesday, following a recent federal court decision that declared the denial of the coverage unconstitutional.

State Treasurer Dale Folwell and the State Health Plan Board of Trustees agreed to restore coverage for “essential medical services” — including hormone replacement therapy and surgery — that the health plan provided for one year in 2017.

Folwell, calling the federal court ruling “legally erroneous,” said he would appeal to the US Court of Appeals for the Fourth Circuit. He said that for now he will do what the judge has ordered.

“We obviously disagree with the judge’s order to, in fact, take responsibility for determining the value of sex-related behavior,” Folwell said.

US District Judge Loretta Biggs ruled in June that the state’s health care policy discriminates against people who are not of the same sex, violating the equal protection provisions of the Constitution and Title VII of the Civil Rights Act because of sex.

Overseen by Folwell’s office, the health plan provides health care to more than 750,000 teachers, government employees, retirees, lawmakers and their dependents.

Several current and former state employees and their dependents sued Folwell, the plan’s administrator, state universities and other government agencies in 2019 for ceasing coverage of essential medical procedures after the state mandated them.

Former state treasurer Janet Cowell and the health watchdog voted in December 2016 not to mandate surgical and hormonal treatment for gender dysphoria for a year. They estimated the annual cost of such coverage would be several hundred thousand dollars, depending on the plan. Exceptions have been made again under Folwell, a Republican, who took office in 2017.

Biggs wrote in his decision that doctors, medical organizations and third-party regulators have accepted procedures to confirm that same-sex couples “may be clinically necessary to treat dysphoria” in some cases.

“I’ve always said that if the legislature or the courts told me we should provide sex-related services, I would,” Folwell said, adding that he was disappointed the court did not bring the case before a jury.



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