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Case No. 18-1158

Eerieanna Good and Carol Beal
Iowa Department of Human Services

The Iowa Department of Human Services (IDHS) appeals from a district court ruling on judicial review that reversed IDHS’ decision to deny Medicaid coverage to the petitioners for surgical procedures related to their gender dysphoria. The district court concluded Iowa Administrative Code rule 441-78.1(4), which prohibits Medicaid coverage for gender-affirming surgery, violates the Iowa Civil Rights Act and the equal protection clause of the Iowa Constitution. On appeal, IDHS argues: 1) transgender Medicaid beneficiaries are similarly situated to, and treated the same as, all other Medicaid beneficiaries; 2) IDHS is not a “public accommodation” under the Iowa Civil Rights Act when it makes a benefits determination; and 3) rule 441-78.1(4) does not violate the Iowa Constitution’s equal protection guarantee because it does not discriminate against a protected class and it serves an important government purpose.

Trial Court Case No.:


Eerieanna Good and Carol Beal


Iowa Department of Human Services

Attorneys for the Appellee

Rita Bettis Austen
John Knight
F. Thomas Hecht
Tina B. Solis
Seth A. Horvath

Attorneys for the Appellant

Anagha Dixit
Matthew K. Gillespie

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