State Treasurer Dale Folwell prohibited the State Health Plan from covering gender-affirming care. Photo by Jade Wilson.

On Thursday, John Knepper, an attorney for North Carolina’s State Health Plan, told the U.S. Court of Appeals for the Fourth Circuit in Richmond, Virginia, that excluding gender-affirming care did not amount to discrimination against transgender people, but rather was a tradeoff born of limited resources.  

The plan, he said, makes tough choices on what procedures it covers for its 700,000-plus members. It doesn’t cover IVF treatments, certain infant formulas, proton-beam therapy for cancer, or breast augmentation to treat gender dysphoria.  […]

Jeffrey Billman is a politics and law reporter for The Assembly. The former editor-in-chief of INDY in Durham, he holds a master's degree in public policy analysis from the University of Central Florida.

Michael Hewlett is a courts and law reporter for The Assembly. He was previously a legal affairs reporter at the Winston-Salem Journal and has won two Henry Lee Weathers Freedom of Information Awards.