Blue Cross Blue Shield Illinois victory gender-affirming care health plan U.S.

Thousands of transgender people in Blue Cross Blue Shield of Illinois-administered health plans will have access to the health care they need.

Blue Cross Blue Shield of Illinois has been instructed by a U.S. District Court Judge to cease imposing discriminatory exclusions on gender-affirming care in all of its health plans across the country. This ground-breaking decision came in the case of C.P. et al., v. Blue Cross Blue Shield of Illinois, a class action lawsuit filed by Lambda Legal and Sirianni Youtz Spoonemore Hamburger PLLC in the U.S. District Court for the Western District of Washington in Tacoma. The case was initially filed by C.P., a now 18-year-old transgender young man, and his parents. The original plaintiffs have been joined by S.L, a 12-year-old transgender girl, by and through her parents, and Emmett Jones, a transgender man. The lawsuit alleged that BCBSIL's administration of exclusions of gender-affirming care violates the health nondiscrimination law enacted as part of the Affordable Care Act, known as Section 1557.

The Court's Order forbids BCBSIL from applying such discriminatory exclusions even when requested to do so by an employer, with no exception for religious employers. Furthermore, BCBSIL has been ordered to reprocess claims for gender-affirming care that it previously denied, going back to October 30, 2014. This ruling is the first in the country to order a third-party administrator, like BCBSIL, to refrain from administering discriminatory exclusions at the behest of employers. Millions of Americans receive their health coverage in self-funded plans that are managed by third-party administrators which are also subject to anti-discrimination laws.

The Court's decision is a significant victory for transgender individuals, as it ensures that thousands of transgender people in BCBSIL-administered health plans will have access to the health care they need. The Court's ruling sends a clear message that health companies governed by the Affordable Care Act cannot engage in discrimination, even when asked to do so by an employer. This decision is a step towards ensuring that no one should be denied needed medical care because of their sex.

The case is being litigated by Counsel and Health Care Strategist Omar Gonzalez-Pagan, Chief Legal Officer Jennifer C. Pizer, and Director of Constitutional Law Practice Karen Loewy for Lambda Legal, and Eleanor Hamburger and Daniel Gross of Sirianni Youtz Spoonemore Hamburger PLLC, in Seattle, Washington. The Court's decision is a significant victory for transgender individuals, as it ensures that thousands of transgender people in BCBSIL-administered health plans will have access to the health care they need.

Share With Others