HOUSTON COUNTY, Ga. — A federal appeals court agreed to rehear a lawsuit against the Houston County Sheriff's Office, tossing out a previous decision finding the county's health insurance policy was discriminatory against transgender employees.
The lawsuit centers on part of the county's health insurance policy that denies coverage for "services and supplies for a sex change" along with "drugs for sex change surgery."
Anna Lange, a former investigator with the sheriff's office, sued the county after they denied coverage for her gender reassignment surgery.
According to court records, after pushing the procedure back, four of Lange’s doctors recommended the “medically necessary” surgery. Because the procedure would cost $20,000, Lange asked the county’s health insurance provider BlueCross BlueShield to cover it.
But after the county pointed to the exclusion, the insurance company denied Lange’s request.
In a 2-1 decision back in May, the 11th Circuit Court of Appeals found that the policy was discriminatory since they denied her coverage for "medically necessary" gender-affirming surgery because she was transgender.
"By drawing a line between gender-affirming surgery and other operations, the plan intentionally carves out an exclusion based on one's transgender status," the federal appeals court originally found. "Lange's sex is inextricably tied to the denial of coverage for gender-affirming coverage."
But in an appeal filed with the court in June, Houston County argues the judges incorrectly interpreted federal discrimination laws and previous court decisions. They argue the exclusion is not discriminatory since it's about a specific procedure and not a protected characteristic, the lawsuit says.
“This shows that coverage depends on the treatment requested, not who is requesting it,” the county’s attorneys wrote. “Accordingly, the Health Plan exclusions do not discriminate because of sex or transgender status.”
The U.S. Department of Justice, who argued in support of Lange's attorneys, disagreed.
They say that mastectomies — the surgery where a person's breast is removed — are covered when the procedure is necessary for cancer treatment but denied for a "medically necessary" gender transition.
"Thus, given the 'undisputed' fact that the challenged provisions of the plan deny coverage 'only for transgender members,' the court held that the plan facially discriminates based on sex," the DOJ wrote.
The case will be heard en banc, when all 12 judges of the 11th Circuit Court of Appeals will hear the case. That comes after the majority of judges in the 11th Circuit agreed to rehear the case.
According to Lange's attorney, Houston County has spent over $1 million fighting the lawsuit, which centers on a procedure that cost $20,000.
The case was first heard in the U.S. District Court for the Middle District of Georgia, which found in favor of Lange and awarded her $60,000 in damages.