Governor Patrick Morrisey praised a decision by the U.S. Court of Appeals for the Fourth Circuit on March 10 that allows West Virginia to enforce its policy limiting Medicaid coverage for gender transition procedures.
The ruling is significant as it affirms the state’s authority to set limits on taxpayer-funded healthcare programs, an issue that has drawn attention in legal and political circles. The case, Anderson v. Crouch, challenged West Virginia’s exclusion of coverage for gender-affirming surgical procedures under its Medicaid program.
“As the former West Virginia Attorney General who spent years defending common-sense policies that protect women and ensure responsible use of taxpayer dollars, I’m grateful the court recognized West Virginia’s authority to set reasonable limits on taxpayer-funded healthcare,” Governor Morrisey said. “States have a responsibility to manage public programs responsibly, and today’s ruling is an important victory for common sense and the taxpayers of West Virginia.”
Anderson v. Crouch was first filed in the U.S. District Court for the Southern District of West Virginia, where a judge found the exclusion discriminatory—a decision later affirmed by the Fourth Circuit in 2024. However, after the U.S. Supreme Court ruled in United States v. Skrmetti, clarifying states’ authority over certain medical treatment policies, it vacated the earlier Anderson v. Crouch decision and directed further review.
Following this direction from the Supreme Court, the Fourth Circuit reconsidered Anderson v. Crouch and issued its latest ruling permitting enforcement of West Virginia’s Medicaid policy. The case originated during Morrisey’s tenure as Attorney General and has been closely watched amid similar legal challenges nationwide.
Observers say this decision could influence how other states approach Medicaid coverage policies related to gender-affirming care.
