A federal judge in Washington state has granted a class action against Blue Cross Blue Shield of Illinois that accuses the payer of denying gender-affirming care coverage under a self-funded health plan, thereby violating the anti-discrimination provision of the ACA.
In the Nov. 9 court decision, U.S. District Judge Robert Bryan certified the class action to represent up to 1,740 people who are covered under self-funded plans and who were or could still be denied transgender care coverage.
The original lawsuit was filed in 2020 by a transgender teenager and his mother, who were provided health coverage through her employer under the Catholic Health Initiatives Medical Plan. The plan was administered by BCBS and included a transgender care exclusion clause. BCBS said 95 percent of the 398 self-funded plans it administers includes the same clause.
BCBS also argued that its activities as a third-party administrator are not subject to the anti-discrimination provisions in Section 1557 of the ACA.
"Class members' individual medical services are not relevant to this portion of their requested relief,'' the judge wrote. "The harm alleged — Blue Cross's alleged discriminatory conduct in the processing of their claims — is common to all the class members."