California announces ban on travel to Iowa, because of Iowa’s new ban on Medicaid paying for gender confirmation procedures

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Illustration by Jav Ducker

California will impose a ban on state-funded and state-sponsored travel to Iowa starting on Oct. 4, California Attorney General Xavier Becerra announced on Friday. The travel ban is a response to a bill Iowa Gov. Kim Reynolds signed into law in May, which prohibits the use of Medicaid funds for gender reassignment surgery that doctors have determined to be medically necessary.

In 2016, California passed a law restricting travel “to states that enact a law after June 26, 2015 that voids or repeals an existing state or local protection against discrimination on the basis of sexual orientation, gender identity, or gender expression.”

“The Iowa Legislature has reversed course on what was settled law under the Iowa Civil Rights Act, repealing protections for those seeking gender-affirming healthcare,” Becerra said in a written statement. “California has taken an unambiguous stand against discrimination and government actions that would enable it. That’s why my office is adding Iowa to the list of states subject to state-funded or sponsored travel restrictions.”

There are 10 other states currently on that list: Alabama, Kansas, Kentucky, Mississippi, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee and Texas.

The Medicaid funding restriction was a provision of the bill Reynolds signed in May, and meant to circumvent a March ruling by the Iowa Supreme Court. In that decision, the justices ruled unanimously that the state’s ban on the use of Medicaid funds for sex reassignment procedures violated the Iowa Civil Rights Act, which was amended in 2007 to prohibit discrimination based on actual or perceived sexual orientation or gender identity,

The ruling came in a case brought by two transgender Iowans, Carol Ann Beal and EerieAnna Good, who sued DHS after the agency decided to deny Medicaid coverage for transition-related procedures ordered by their doctors.

As ACLU of Iowa Legal Director Rita Bettis Austen noted at the time, “Today’s decision is historic for civil rights in Iowa, because it is the first Iowa Supreme Court case to recognize the right that transgender Iowans have to nondiscrimination under the Iowa Civil Rights Act in Medicaid — or by any other public accommodation.”

Iowa Senate Republicans added a last-minute amendment to the Department of Human Services budget bill that created a ban almost identical to the one the court overturned. Sen. Jake Chapman, R-Adel, said he considered sex reassignment and gender confirmation procedures to be “an elective decision. If Iowans want to do that, that’s fine, but not with our taxpayer dollars.”

Sen. Joe Bolkcom of Iowa City pushed back against the amendment during a brief debate that the Senate leadership allowed, saying, “It’s ignorant. It’s discrimination of the worst kind.” Bolkcom, a Democrat, pointed out that the state doesn’t refuse to provide Medicaid funds for other procedures deemed medically necessary. “We don’t ask when someone has cancer: ‘Geez, what’s that going to cost?’” he said. “’Well, that’s too much.’”

Gov. Reynolds could have removed the amendment using her line-item veto, but chose not to.

Reynolds also did not issue a statement when she signed the DHS bill into law. Instead, her office included the bill on a list of 13 bills she signed in a Friday afternoon press release. The description of the bill in the press release did not mention the amendment.

Little Village emailed the governor’s office to ask if Reynolds had any comment on the California travel ban, but has not yet received a reply.


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There are a limited number of exceptions included in the California travel ban, including travel to conduct litigation or collect revenue owed to the state. In practical terms, the travel ban will make little difference, since California officials seldom travel to Iowa, although since the ban applies to the state’s colleges, it would prevent any teams from those schools participating in tournaments held in Iowa.

But according to the text of the law, the point of the ban is not to affect the economy of other states, but to ensure the state of California’s actions aren’t “supporting or financing discrimination against lesbian, gay, bisexual, and transgender people.”

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