Transgender U. of Arizona Professor Files Class Action Over Alleged Healthcare Discrimination [UPDATE]
by Nadia Abbas
Last Updated on October 6, 2023
Toomey v. State of Arizona, et al.
Filed: January 23, 2019 ◆§ 4:19-cv-00035-LCK
A University of Arizona professor has filed suit over claims that the state’s employee healthcare plan unlawfully denies transgender members coverage for transition-related procedures.
Arizona
October 6, 2023 – Deal Reached in Arizona Trans Healthcare Lawsuit
After an extensive procedural history and negotiations, the parties involved in the lawsuit detailed on this page have reached a deal that the court approved on September 28, 2023.
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In a 16-page order approving the consent decree between the plaintiff, the State of Arizona, the Arizona Board of Regents and several individual defendants, U.S. District Judge Rosemary Marques stated that the agreement “offers substantial benefits to the class, who give up very little, if anything, in return.”
Under the consent decree, the defendants are permanently prohibited from excluding coverage for medically necessary gendering-affirming surgeries in Arizona’s employee healthcare plan. The consent decree also requires the defendants to evaluate health claims for surgical care to treat gender dysphoria according to the health plan’s generally applicable standards and procedures.
Although the agreement does not provide the plaintiff or other affected state employees financial relief, the defendants agreed to pay the plaintiff’s counsel $500,000 in attorneys’ fees.
However, according to the order, Judge Marques cut the attorney fee award down to $375,000 because “such a significant portion of the relief obtained cannot be attributed to class counsel’s efforts in this matter.”
The judge specified that on June 27 of this year, Arizona Governor Katie Hobbs, independent of the parties’ negotiations, issued an executive order requiring the state employee healthcare plan to cover medically necessary gender-affirming healthcare.
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The University of Arizona’s board of regents joins two state Department of Administration officials and the state itself as defendants in a professor’s lawsuit that claims Arizona’s employee healthcare plan unlawfully denies transgender members coverage for transition-related procedures. Filed by the American Civil Liberties Union Foundation and ACLU Foundation of Arizona, the suit seeks declaratory and injunctive relief that would provide healthcare plan members with the opportunity to have their transition-related claims evaluated under the same standards as other medical treatments under the state’s employee healthcare plan.
According to the proposed class action, the plaintiff, a transgender man, was denied coverage for a prescribed hysterectomy in August 2018 based solely on his healthcare plan’s “categorical ban” on gender reassignment surgeries. The suit explains that the plan covers all procedures that are deemed medically necessary yet “singles out” transgender members by denying all claims related to gender reassignment, regardless of whether the procedure meets the plan’s usual standards for required treatment. The lawsuit says the defendants’ alleged discrimination against transgender University of Arizona employees violates the Civil Rights Act of 1964, as well as the 14th Amendment’s Equal Protection Clause.
Although healthcare plan members typically reserve the right to appeal any denial of coverage to a third-party claims administrator, the complaint alleges that individuals who require gender reassignment surgeries are discriminated against in that they “have no opportunity to demonstrate that their transition-related care is medically necessary,” nor the option to appeal any decision.
The suit points out that while the plan’s four network providers—Aetna, Blue Cross Blue Shield of Arizona, Cigna and UnitedHealthcare—have their own protocols for determining when transition-related care is medically necessary, the plan’s outright exclusion of coverage automatically denies the companies the opportunity to evaluate plan members’ claims. According to the lawsuit, the defendants’ seemingly illogical ban on procedures that would otherwise be covered absent gender reassignment purposes is rooted in discrimination.
“The Plan’s discriminatory exclusion lacks any rational basis and is grounded in sex stereotypes, discomfort with gender nonconformity and gender transition, and moral disapproval of people who are transgender,” the case argues.
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