The Supreme Court on Monday ruled that it would not block access to a group of trans people seeking medical care, a landmark decision that could spur new protections for trans people.
In a 5-4 decision, the justices said the Department of Health and Human Services (HHS) had not yet made a sufficient showing of a “compelling interest” to require insurance companies to provide coverage to trans people, meaning that the government could not prohibit insurance companies from denying coverage to them.
The court also said that the HHS has not adequately demonstrated that the protections are medically necessary and necessary to protect the health and safety of the individual.
The case has sparked renewed calls for a nationwide health care overhaul, including for protections for transgender people, and a push by Democrats in Congress to pass a bill by the end of this year that would provide health insurance to trans Americans.
Transgender people have been among the most underrepresented groups in health insurance, with one in five Americans identifying as a member of a minority group.
The ruling was expected, but was not expected to alter the Trump administration’s efforts to roll back transgender rights and other legal challenges.
The decision has already sparked a backlash in many parts of the transgender community, with the Human Rights Campaign, the nation’s largest LGBT rights group, calling it “deeply disappointing” and “an important victory for the trans community.”
“This decision is a step in the right direction and a significant step toward a future where transgender people can have access to quality health care in their own communities, regardless of who they are,” HRC President Chad Griffin said in a statement.
Trans people have long been excluded from the federal health insurance program known as the Medicaid program, which provides health insurance benefits to low-income people in the United States.
Under the Affordable Care Act, the federal government covers health insurance for all Americans regardless of gender identity or sexual orientation.
Under current law, the Medicaid expansion covers only transgender people.
The Supreme Court’s decision could lead to more coverage for transgender Americans.
In recent years, several states have extended Medicaid to transgender people under the law, but not all have offered transgender residents the same coverage.
A decision on whether to extend Medicaid coverage for trans individuals could impact the lives of tens of thousands of people across the country, according to the National Center for Transgender Equality.
The justices said that because the HHS had not made an adequate showing of the medical necessity for coverage under the ACA, the government cannot prevent insurers from denying that coverage.
But the ruling did not extend coverage to people who already had coverage under state programs that cover gender dysphoria.
Under those state programs, some transgender people may have been denied coverage due to discrimination and stigma, according the Center for American Progress, a progressive advocacy group.
Other states that have expanded coverage to transgender residents include Arizona, California, Florida, Hawaii, Iowa, Kansas, Maine, Massachusetts, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, Vermont, Virginia, and Washington.
The Trump administration has also sought to weaken Medicaid coverage, and the Supreme Court has said that it will review whether to hear the case.
Trump has made repealing the ACA his signature policy and has called for the government to stop covering insurance companies for discrimination based on gender identity and sexual orientation, a position that could lead him to reverse his previous position and allow trans people to get coverage.
President Donald Trump speaks to the media after delivering remarks at the American Legion Convention at the Convention Center in Chicago, Illinois, U.S., July 21, 2021.
PresidentDonald Trump speaks with reporters after delivering comments at the British Columbia International Film Festival, at the BICF convention center in Vancouver, British Columbia, U, July 21 to the Biju Theatre, Vancouver, B.C., July 22, 2021, to celebrate the opening of the 2018 Bijuan Film Festival.
The administration has said it will not defend its decision in court, saying that it is “a matter for the courts.”
It was unclear when the ruling would come down, though the justices did say that the justices would consider whether to “make a ruling on the merits or on a matter not before the court.”