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Court Ruling Limiting Adult Gender-Affirming Medicaid Coverage Could Have National Impacts

The unanimous ruling could make it easier for states and insurers to deny coverage, with 11 states already banning Medicaid funding for such care.

  • The 4th U.S. Circuit Court of Appeals overturned a lower court decision in Anderson v. Crouch, unanimously upholding West Virginia's ban on Medicaid coverage for adult gender-affirming surgeries.
  • This ruling follows the Supreme Court's decision last year in Skrmetti, which upheld Tennessee's ban on gender-affirming care for youth, prompting the panel to vacate prior rulings.
  • Carmel Shachar of Harvard Law School said the ruling makes denying coverage easier, noting private insurers might feel "a little more comfortable" after this case.
  • In Oklahoma, Republicans are advancing legislation to prohibit Medicaid funds from covering adult gender-affirming care, which passed the Senate last month and a House oversight committee 11-2 last week.
  • Hailey Briggs of Oklahomans For Equality said the bill is a "sweeping attempt" triggering fear in the community, while Shannon Minter warned the ruling could lead to more discrimination.
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Pennsylvania Capital-StarPennsylvania Capital-Star
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Court ruling limiting adult gender-affirming Medicaid coverage could have national impacts

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stateline.org broke the news on Friday, April 24, 2026.
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