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Case No. 21-1977

Aiden Vasquez and Mika Covington
Iowa Department of Human Services

Petitioners are Iowa Medicaid beneficiaries who were denied Medicaid coverage for gender-affirming surgery. Petitioners sought judicial review arguing Iowa Administrative Code rule 441—78.1(4)—which excludes Medicaid coverage for surgical procedures related to gender identity disorders—violates the Iowa Constitution’s equal-protection clause and the Iowa Civil Rights Act’s (ICRA) prohibitions on gender-identity and sex discrimination. Petitioners further argued that a recent amendment to ICRA—which states that ICRA’s public accommodation protections do not require the State or local governments to provide gender-affirming surgery—violates the equal protection clause of the Iowa Constitution. The district court held that rule 441—78.1(4) and the amendment to ICRA both violate the equal protection clause. The district court further held that petitioners’ ICRA claims were barred because petitioners failed to exhaust their administrative remedies. The district court also denied petitioners’ requests for attorney’s fees under ICRA. The Iowa Department of Human Services appeals and the petitioners cross-appeal from the district court’s ruling.



Aiden Vasquez and Mika Covington


Iowa Department of Human Services

Attorneys for the Appellee

Rita Bettis Austen
Shefali Aurora
Lisa Nowlin-Sohl
F. Thomas Hecht
Tina B. Solis
Seth A. Horvath

Attorneys for the Appellant

Samuel P. Langholz
Thomas J. Ogden

Other Information

Date Retained:
Sep 27, 2022

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