A federal appeals Court in Virginia ruled on Monday that state health plans must cover transgender healthcare.

The decision was a result of the battles that West Virginia and North Carolina had fought over refusing to cover certain health care for transgender individuals with government-sponsored insurance.

The Richmond-based U.S. The 4th U.S.

West Virginia Attorney-General Patrick Morrisey released an immediate statement to announce his office’s intent to appeal.

Morrisey stated that “Decisions such as this, made by a court presided over by Obama and Biden appointees, are not to be accepted: We will take this case up to the Supreme Court, and we will win.”

Shauntae Anderson (a Black transgender woman who is enrolled in West Virginia Medicaid) called the refusal of her state to pay for her medical care “deeply humanizing” after the ruling.

Anderson, in a press release, said: “I’m so relieved to see that this court decision brings us closer to a day when Medicaid will no longer deny access to essential healthcare for transgender West Virginians that our doctors have determined is important to us.”

During the oral arguments held in September, two judges at least said that it was likely the case would eventually reach the U.S. Supreme Court.

Both states appealed separate rulings from lower courts that found the denial gender care as discriminatory and unconstitutional. Last year, two panels of three Fourth Circuit Judges heard arguments in the cases before deciding to combine the cases and present them before the entire court of 15

A North Carolina trial judge demanded in June 2022 that the state plan cover “medically essential services” including hormone therapy and certain surgeries for transgender workers and their children. The judge ruled that the state plan should cover the costs of gender-related healthcare for employees and their children.

North Carolina’s state insurance plan covers more than 750,000 teachers and state employees as well as retirees, legislators, and their dependents. It covers counseling for gender dysphoria, but not treatment related to sex modifications or changes.

A federal judge ruled in August 2022 that West Virginia Medicaid must cover such care for residents who are transgender.

A lawsuit originally filed in 2020 also named the state employee health plans. In 2022, a settlement reached with The Health Plan of West Virginia Inc. led to the removal of gender-related exclusions in the Public Employees Insurance Agency Plans of that company.