C.P. v. Blue Cross Blue Shield

C.P. v. Blue Cross Blue Shield

Opinion

ORDER ON CROSS MOTIONS FOR SUMMARY JUDGMENT

This matter comes before the Court on the Defendant Blue Cross Blue Shield of Illinois' ("Blue Cross") Motion for Summary Judgment (Dkt. 87), and the Plaintiffs' Cross Motion for Summary Judgment (Dkt. 96), and Plaintiffs' motion to strike (Dkt. 126). The Court has considered the pleadings filed in support of and in opposition to the motions, oral argument heard on 12 December 2022, and the file herein.

In this case, Plaintiffs C.P., a transgender male, and his mother, Patricia Pritchard, claim that [*2]  Blue Cross violated the anti-discrimination provision of the Affordable Care Act ("ACA"), 42 U.S.C. § 18116, when it administered discriminatory exclusions of gender-affirming care in a self-funded health care plans governed by the Employee Retirement Income Security Act of 1974 ("ERISA"). Dkt. 1. The Plaintiffs' motion to certify a class of similarly situated people was granted on November 9, 2022 (Dkt. 113) and amended on December 12, 2022 (Dkt. 143).

Blue Cross moves for summary judgment on Plaintiffs C.P. and Ms. Pritchard's claims. Dkt. 87. Plaintiffs C.P. and Ms. Pritchard cross move for summary judgment on their claims as well as the class claims. Dkt. 96. For the reasons provided below, Blue Cross's Motion for Summary Judgment (Dkt. 87) should be denied and Plaintiffs' Motion for Summary Judgment (Dkt. 96) and motion to strike (Dkt. 126) should be granted.

I. RELEVANT FACTS, PROCEDURAL HISTORY, AND STATUTORY BACKGROUND

A. FACTS

Named Plaintiffs are C.P., a boy of seventeen, and his mother, Ms. Pritchard. Dkt. 38. C.P. is a transgender male, which means that he has a male gender identity even though the sex assigned to him at birth was female. Id. C.P. has been living as a male since around 2015. Dkt. 94-1 at 135.

Ms. Pritchard receives health care coverage through her employer under [*3]  the Catholic Health Initiatives ("CHI") Medical Plan ("the Plan") and C.P. is enrolled in that Plan as her dependent. Dkts. 81; 97-12 at 8. The Plan is "self-funded" - Ms. Pritchard's employer directly assumes financial responsibility for employees and their dependents' health care costs. Dkt. 88-1 at 11.

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