Plaintiffs include (from left) Max Kadel and Julia McKeown. Courtesy Lambda Legal/TLDEFThe Supreme Court has declined to hear an appeal from the North Carolina State Health Plan, therefore letting stand a lower court’s ruling that the plan can indeed be sued over denial of gender-affirming health care to state employees and their dependents.Lambda Legal and the Transgender Legal Defense and Education Fund are suing the plan on behalf of several state employees over its blanket exclusion of such care, saying the plan violates the Affordable Care Act’s ban on discrimination.

State officials contended the plan was protected from such suits because of sovereign immunity, “the legal doctrine that precludes bringing a lawsuit against the state without its consent,” as Lambda Legal explains.

The state also claimed the ACA’s discrimination ban was unclear.In 2020, the U.S. District Court for the Middle District of North Carolina ruled that the plan could be sued, saying the state had waived its sovereign immunity by accepting federal funds.