This week, the US Supreme Court (SCOTUS) vacated the judgments of three appellate courts and sent the cases back “for further consideration in light of United States v. Skrmetti.” The cases addressed laws in four states dealing with coverage for gender transition procedures and other related matters. Specifically for North Carolina, SCOTUS ordered the 4^th Circuit Court of Appeals to reconsider a decision made in April 2024, which determined that it was unconstitutional for the State Health Plan to exclude coverage for gender transition procedures. This case was originally brought before the 4th Circuit Court in Kadel v. Folwell.

In a news release responding to this order, State Treasurer Brad Briner’s office said, “Once the full legal process is finalized in the coming weeks, we anticipate this will lead to the State Health Plan of North Carolina re-implementing the longstanding exclusion on transition-related medical care.”

North Carolina’s History in This Area

Since the 1990s, North Carolina leaders have prevented taxpayers’ dollars from funding any type of gender transition procedures. Former State Treasurer Dale Folwell courageously engaged in a years-long legal battledefending this decision in court. In a press release in April 2024, he shared, “Our priority is to provide coverage that does the most good for the highest number of people with the finite resources we have available.” Despite the legal battles, this policy remained intact until 2024, when the 4^th Circuit released its 8-6 decision finding this policy to be “discriminatory.”

While the 4^th Circuit has yet to release any further opinions in regard to Kadel v. Folwell, it appears likely that North Carolina will once again prevent gender transition procedures from being paid for by the State Health Plan. NC Family is grateful to leaders like State Treasurers Dale Folwell and Brad Briner for championing this policy, and to SCOTUS for prompting the 4^th Circuit Court to reconsider its decision.