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North Carolina State Health Plan Reinstates Exclusion on Transition-Related Treatments

A Supreme Court directive tied to the Skrmetti ruling led the Fourth Circuit to void the prior injunction, prompting the plan’s change.

Overview

  • Coverage for puberty blockers, cross-sex hormones and gender-affirming surgeries is now excluded, while psychological assessment and psychotherapy related to gender dysphoria remain covered.
  • The Fourth Circuit on Sept. 23 vacated the 2022 district court order requiring coverage and remanded the case, with the mandate reaching the trial court on Wednesday.
  • The case returns to the Middle District of North Carolina without a judge currently assigned.
  • Treasurer Brad Briner announced implementation and said about 500 members could be affected out of roughly 750,000 covered by the plan.
  • Earlier wins for the plaintiffs at trial and on appeal were undone procedurally after the Supreme Court’s June order directing reconsideration in light of United States v. Skrmetti.