ACLU challenges Iowa law restricting public funds for transgender medical care

By: - April 22, 2021 5:21 pm

A Polk County judge has ruled that a state law denying Medicaid coverage for gender-confirmation surgery violates the Iowa Constitution and the Iowa Civil Rights Act. The case was filed on behalf of Aiden Vasquez, shown here, and Mika Covington. (Photo courtesy of the ACLU of Iowa)

The American Civil Liberties Union of Iowa filed a lawsuit Thursday against a state law that exempts Medicaid and other public insurance plans from funding transition-related surgeries for transgender individuals.

The national ACLU LGBTQ & HIV Project and the ACLU of Iowa filed the lawsuit jointly on behalf of Aiden Vasquez, a transgender Iowan who uses Medicaid.

“It’s hard knowing that the state has gone out of its way to discriminate against me and block my medical care just because I’m transgender, when other Iowans on Medicaid are able to get coverage for the surgeries they need,” Vasquez told reporters in a Thursday press conference.

Vasquez and the ACLU filed a similar suit in 2019 against the same law. The Iowa Court of Appeals dismissed the case because Vasquez and fellow plaintiff Mika Covington had not been denied coverage by the Iowa Department of Human Services.

Vasquez has since applied for and been denied coverage by the Department of Human Services, allowing the lawsuit to begin anew.

“We are frustrated, our clients are frustrated, we know Iowans are frustrated that the state keeps putting into place this discriminatory policy,” ACLU of Iowa Legal Director Rita Bettis Austen said.

The Department of Human Services has not yet denied coverage to Covington. If it does, she will join the lawsuit with Vasquez.

“I am currently forced to live in a body that does not align with my gender, the gender that I am in my mind and in my heart,” Covington said at Thursday’s press conference. “It affects every aspect of my life, creating tremendous stress that triggers anxiety attacks, anguish and other health problems.”

Looking back: How did we get here?

Sept. 21, 2017: The ACLU of Iowa filed a lawsuit on behalf of two transgender Iowans, EerieAnna Good and Carol Ann Beal, to challenge a law that exempted “surgeries for the purpose of sex reassignment” from Medicaid coverage.

March 8, 2019: The Iowa Supreme Court ruled that the transgender surgery ban violated Iowa Civil Rights Act. Vasquez, who was not a plaintiff in that lawsuit, told the Des Moines Register that Iowa was “finally acknowledging that this is not a plastic surgery or about what I look like.”

“This is a matter of life and death,” he said.

April 26, 2019: In response to that ruling, Republican lawmakers amended the Iowa Civil Rights Act to say Medicaid and other public insurance plans are not required to fund transition-related surgeries.

May 31, 2019: The ACLU filed a lawsuit on behalf of Vasquez and Covington against that law, hoping to temporarily block it.

July 18, 2019: A Polk County judge dismissed the challenge, saying it was too early for courts to consider the law. The ACLU appealed the decision.

Aug. 5, 2020: The Iowa Court of Appeals dismissed an appeal because neither Covington or Vasquez had actually been denied by the Department of Human Services.

April 22, 2021: Now that Vasquez has been denied for transition-related surgeries, the lawsuit begins again.

“I have seen too many other transgender people suffer because they are unable to get the care they need,” Vasquez said Thursday.

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Katie Akin
Katie Akin

Reporter Katie Akin began her career as an intern at PolitiFact, debunking viral fake news and fact-checking state and national politicians. She moved to Iowa in 2019 for a politics internship at the Des Moines Register, where she assisted with Iowa Caucus coverage, multimedia projects and the Register’s Iowa Poll. She became the Register’s retail reporter in early 2020, chronicling the impact of the COVID-19 pandemic on Central Iowa’s restaurants and retailers.