Missouri Supreme Court upholds ban on Medicaid coverage for gender-affirming carehttps://www.advocate.com/politics/missouri-supreme-court-transgender-medicaid 🔗Ryan Adamczeski (14 Jan 2026)
The Missouri Supreme Court has upheld a law that prevents Medicaid from covering gender-affirming care for transgender people of all ages.
The court ruled unanimously on Tuesday in E.N. v. Kehoe (formerly Noe, et al. v. Parson, et al.) that the state's 2023 law can stand, preventing those on the federal and state insurance programs from accessing the care for the purpose of gender transition, while allowing it for other conditions.
"Today is a disgraceful day as the courts once again failed Missourians," Katy Erker-Lynch, executive director of state LGBTQ+ policy group PROMO, said in a statement. "The Missouri Supreme Court let lies and disinformation dictate what our law should be rather than best healthcare practices recommended by every major medical association in this country."
Senate Bill 49, which Republican Gov. Mike Parson signed into law in June 2023, banned gender-affirming care for youth, while allowing those already receiving treatment to continue. The law also banned Medicaid from covering gender-affirming care — even for adults — and gender-affirming surgeries for incarcerated people. The same treatments are still legal for cisgender patients experiencing conditions such as early-onset puberty or a disorder of sex development.
