Iowa Medicaid has no explicit policy regarding transgender-related health care.
Good v. Iowa Dep’t of Human Servs., No. CVCV055470 (Iowa Dist. Ct. Jun. 6, 2018) aff’d Good v. Iowa Dep’t of Human Servs., 924 N.W.2d 853 (Iowa 2019)
The Iowa district court struck down Iowa’s categorical Medicaid ban as discrimination under the Iowa Civil Rights Act and the Iowa Equal Protection Clause, as violative of privacy rights, and as unreasonable, arbitrary and capricious. The Iowa Supreme Court held that the exclusion is discrimination under the Iowa Civil Rights Act.
Smith v. Rasmussen, 249 F.3d 755 (8th Cir. 2001)
The Eighth Circuit Court of Appeals declined to overturn a Medicaid surgery ban where hormones were covered but not surgery.
Pinneke v. Preisser, 623 F.2d 546 (8th Cir. 1980)
The Eighth Circuit Court of Appeals struck down Iowa’s Medicaid transgender exclusion, which “reflect[ed] inadequate solicitude for the applicant’s diagnosed condition, the treatment prescribed by the applicant’s physicians, and the accumulated knowledge of the medical community.”
Per the Movement Advancement Project: In March 2019, the Iowa Supreme Court ruled that the state's previous exclusion of transgender health coverage that the state's previous exclusion of transgender health coverage (see 441 IAC 78.1(249A)) violated the state's civil rights law, and therefore was illegal. The decision found that gender-affirming health care is medically necessary and therefore may not be excluded. However, in May 2019, the Iowa governor signed into law a bill (HF 766) that allows Medicaid and other state-funded health care providers to choose not to cover transgender-related care. As a result, the current ability of transgender Iowans to access gender-affirming care through Medicaid is uncertain, and advocates are pursuing clarification (and access to care) through the court system.
Updated on Jun 6, 2020