So uhh, let's break this down.

The ruling is based directly on Bostock's sex protections. It means that even plans which are fully paid by the employer would be bound by this, as long as whichever company runs the processing takes even one red cent of federal money.

The ruling will definitely be appealed to the SC. But unless Roberts and Gorsuch reverse their positions in Bostock, I think this one stands.

Overwhelmingly, fully funded insurance plans are administered by big corps, like BCBS or Aetna. All of those companies take federal $.

All of them. Because of the Health Insurance Marketplace.

And once the standard is on medical necessity, the definitive worldwide standards is WPATH SoC8. Which, if you want to check coverage, I did a write up a few months ago (https://stainedglasswoman.substack.com/p/what-do-wpath-standards-of-care-8).

Or you can check this list. **Everything's** on it.

If this ruling stands, it's over.

We won.

Every last fucking transition-related procedure will have to be fully covered, by federal law. No asterisks. No ifs, ands, or buts.

Everything.

@Impossible_PhD I really hate to rain on this parade, because we absolutely deserve a win, but this ruling is only the start, and its scope is very limited.

As of now, it only ensures that folks with
(1) ERISA-backed insurance plans
(2) in the Western District of Washington
(3) who want to have medically necessary gender affirming procedures covered
will be able to have those procedures covered.

@Impossible_PhD

The case does NOT decide what medically necessary care is OR that SOC-8 is an automatic green light, just that you can't have a blanket ban on gender affirming care. The case could (and very likely will) be appealed, and the appellate court could take a very different view on things.

It's a great start for sure! and something that I was really hoping would happen after Bostock. But most insurance providers aren't bound by the decision.

@control_shift_z WPATH is, per BCBS' own internal documentation, the arbiter of medical necessity, so SoC8 is indeed going to be the authoritative document here. Virtually all US insurance plans say the same.

The blanket bans are also common, which make that part of the ruling portable.

And while the judge was in WA, this was a federal judge ruling on an interstate commerce matter, bc the plan and admin were IL. You'll note that every law involved in the judgment was federal.