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A new battle has erupted in the war between the states and the federal government. A Virginia-based federal court last week ruled against states invoking gender-restriction laws to deny Medicaid coverage for some gender-related treatments to transgender residents.

If the case goes to the Supreme Court, and the court sides with the states, might this embolden officials in Texas and other conservative states to deny coverage to immigrants, even if they’re entitled to have it?

It’s a valid question. After all, the state already has denied coverage to many residents, including U.S. citizens in all demographic categories, by rejecting Medicaid expansion that was part of the Affordable Care Act. Might currently eligible immigrants lose access to government-funded health care under a state denial of services?

It could be a major issue for the Rio Grande Valley, where more than 1 in 4 residents were born in other countries and about one-third of all residents have Medicare coverage.

Under current federal law, Medicare can pay for emergency treatment for immigrants, both legal and illegal, under certain conditions. Moreover, legal residents can receive coverage under Medicaid, the Children’s Health Insurance Program and other federal healthcare programs once they have had “qualified non-citizen” status for five years. This would apply to “green card” holders and those with special refugee status, among others.

Many people who seek tighter immigration restrictions contend that immigrants come to this country only to take advantage of government benefits, and thus harm native-American taxpayers. Thus, officials in Texas and other conservative states could seek to deny immigrants access to such benefit programs, including healthcare plans.

Medicaid is a federal program administered jointly with the states. Both fund them and the federal government sets guidelines for their management and application. The federal government, and courts, have held that gender-related restrictions are discriminatory, and thus illegal.

Such opinions haven’t stopped states from trying to deny services to illegal residents, including public school enrollment and lunch programs. To date, those efforts have been struck down, including by several Supreme Court decisions.

The court’s current conservative majority, however, has shown little respect for past decisions and overturned several previous rulings. This has emboldened officials in some states to challenge some of those rulings, and they have succeed in matters such as abortion and voting rights.

Legal experts have long held that except where specifically stated otherwise, the rights guaranteed under the U.S. Constitution are not reserved to citizens but are basic human rights that apply to everyone, regardless of nationality or legal status. This includes provisions prohibiting discrimination and mandating equal protection of the laws.

Ideally, the high court would decide not to take any appeal of the gender-related Medicare denial case, and let the lower court ruling stand. Otherwise, many Valley residents might have reason to fear the loss of the only healthcare coverage they can get.