Groups to sue Florida Medicaid program over ban on gender affirming care

TALLAHASSEE, Fla. — A coalition of transgender-rights organizations is preparing to sue Florida to stop the state’s Medicaid regulator from banning coverage of gender-affirming treatments.

Simone Chriss, director of the Southern Legal Counsel’s Transgender Rights Initiative, said on Wednesday that the coalition is expecting to file the case in federal court and will seek a preliminary injunction to halt the ban from going forward.

“We are trying to get this filed as quickly as we possibly can,” Chriss said. “We were expecting to have a little more time before this actually went into effect.”

The new rules prohibit Medicaid from covering treatments such as puberty blockers, hormone therapies or surgical procedures for gender dysphoria, which refers to the feelings of discomfort or distress some transgender people experience when their bodies don’t align with their gender.

Florida’s Medicaid regulator, the Agency for Health Care Administration, finalized the rules on Thursday and goes into effect Sunday. The agency oversees most of the state’s $36.2 billion federal-state program, which covers almost 5.4 million people.

Chriss said Florida’s ban will affect up to 9,000 of the state’s Medicaid enrollees who are transgender. Florida joins nine other states that have already banned Medicaid dollars from going to gender-affirming care, according to the Movement Advancement Project, a nonprofit research think tank.

“We really want to bring the best possible case and represent the interests of all of the folks who are going to be harmed by this discriminatory rule,” Chriss said, adding that they are choosing a wide range of plaintiffs and people seeking various types of care.

Chriss declined to provide additional details about the upcoming suit but offered harsh criticism of Florida’s Medicaid regulator, saying she questioned the agency's use of the state law that governs rulemaking. She said the agency left no time to consider the thousands of comments that had been submitted about the rule. AHCA first proposed the measure in June, which was followed by a public hearing in July.

Brock Juarez, an AHCA spokesperson, wrote in an email that the rulemaking process used to finalize the Medicaid ban was no different than previous rules.

“The Agency will not comment beyond stating that these attacks are clearly coming from an unscientific and partisan motivated organization posturing for a lawsuit against the rule,” Juarez wrote. “If necessary, we are prepared to defend the integrity of our well established rule making process in court.”

The new rule is just one of the steps taken by Gov. Ron DeSantis to restrict gender-affirming treatments. The governor’s office oversees AHCA and the Florida Department of Health, which asked the state Board of Medicine to consider a ban on gender-affirming treatments for youths in early August.

The board agreed to start discussions and meetings that are part of the state rulemaking process. And the Republican governor has become increasingly vocal in his objections to such treatments.

Chriss said Florida is the only state that has moved to block transgender health care without any input from the Legislature. She pointed to failed attempts by Florida Republican lawmakers to pass gender-care restrictions through the legislative process. Those efforts include HB 211, which was filed during the last legislative session by conservative state Rep. Anthony Sabatini (R-Howey-in-the-Hills) that sought to bring criminal penalties for health care professionals who provide gender-affirming care for children.

Sabatini’s bill died after it failed to make the agenda of its first assigned committee meeting. Chriss said other measures also died without support.

“I think that reflects that the will of the people in the state of Florida — they don't want a discriminatory law like that,” Chriss said. “It's going to push trans folks out of our state if they want equal access to care.”