North Carolina health plan resumes coverage of transgender surgeries – WSB-TV Channel 2


RALEIGH, NC – (AP) – The North Carolina State Employees Health Plan will resume coverage for gender-affirming treatments for transgender employees, the state treasurer said Wednesday, in accordance to a recent federal court ruling that declared the denial of coverage unconstitutional.

State Treasurer Dale Folwell and the state health plan’s board of directors have agreed to restore coverage for ‘medically necessary services’ – including hormone replacement therapy and surgeries – that the plan provided for a single year in 2017.

Folwell, calling the federal court’s decision “legally incorrect,” said he was filing an appeal with the United States Court of Appeals for the Fourth Circuit. He said he would carry out the judge’s orders in the meantime.

“We obviously disagree with the judge’s order which, in essence, takes responsibility for determining plan benefits for gender reassignment operations,” Folwell said.

U.S. District Judge Loretta Biggs ruled in June that the state’s health plan unlawfully discriminates against transgender people, violating both the Constitution’s Equal Protection Clause and Title VII of the Civil Rights Act on the basis of sex.

Overseen by Folwell’s office, the health plan provides medical coverage to more than 750,000 teachers, state employees, retirees, legislators and their dependents.

Several current and former state employees and their dependents had sued Folwell, the plan’s executive administrator, state universities and other government entities in 2019 for dropping coverage for medically necessary procedures once provided by the state.

Former state treasurer Janet Cowell and the health plan’s board voted in December 2016 not to enforce the plan’s exclusion of surgical and hormone treatments for gender dysphoria for a single year. They estimated that the annual cost of such coverage would be several hundred thousand dollars, according to the order. The coverage exclusion resumed under Folwell, a Republican, who took office in 2017.

Biggs wrote in her decision that physicians, medical associations and third-party health plan administrators agreed that gender affirmation procedures “may be medically necessary to treat gender dysphoria” in some cases.

“I have always said that if the legislator or the courts told me that we had to provide gender transitioning operations and treatment, I would do it,” said Folwell, adding that he was disappointed that the court did not took the case to a jury.


Schoenbaum is a member of the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places reporters in local newsrooms to report on underreported issues. Follow her on Twitter at


Comments are closed.