(Hartford, CT) – A coalition of 19 attorneys general filed a lawsuit Thursday against the U.S. Department of Health and Human Services, challenging a federal directive they argue unlawfully seeks to limit access to gender-affirming care for transgender youth by threatening to cut off Medicare and Medicaid funding to providers.
The legal action, led by Connecticut Attorney General William Tong and his counterparts in New York, Oregon, and Washington, targets a document issued by HHS on December 18 that the agency termed a “declaration.” In it, HHS Secretary Robert F. Kennedy Jr. characterized certain forms of gender-affirming care for minors as “unsafe and ineffective” and signaled that providers who continue to offer such care could face exclusion from federal health programs.
The coalition argues that the declaration represents an attempt to impose a sweeping policy change without following required federal rulemaking procedures, including a public notice and comment period. They contend that HHS lacks the authority to dictate medical standards in this manner, noting that Congress has expressly prohibited federal officers from exercising supervision or control over the practice of medicine.
“Trump and RFK Jr. are forcing a radical political agenda on doctors and families and weaponizing Medicare and Medicaid funding to deny healthcare to kids,” Connecticut’s Attorney General William Tong said in a statement. “These extreme actions threaten to decimate medical providers nationwide unless they end gender-affirming care, supplanting medical expertise and parental choice with MAGA ideology. This is cruel and lawless, and we’re suing to block them.”
“These proposed rules are the Trump administration’s latest attempt to undermine the essential rights of youth living with gender dysphoria across the nation, including in states like Illinois that has enacted robust laws to protect their right to receive clinically prescribed healthcare,” Chicago – Attorney General Kwame Raoul said. “These rules greatly exceed the administration’s authority because no federal agency has the power to directly regulate healthcare—a traditional and congressionally recognized power reserved for the states. I will continue to push back on these unlawful policy changes and efforts by the federal government to upset the balance of power between states and the federal government.”
“The Trump Administration is trying to advance cruel and unlawful new rules that seek to deny transgender Americans access to crucial care,” said California’s Attorney General Bonta. “The Trump Administration continues to overstep its authority in pursuit of a hateful agenda against transgender individuals’ rights. If HHS attempts to finalize rules that are similar to these proposals, we stand ready to use every tool in our toolbox to prevent them from ever going into effect. We are committed to defending California and other states’ rights to administer their healthcare programs. We will continue to fight to safeguard patients and their trusted healthcare providers from Trump’s baseless attacks.”
The declaration was accompanied by two proposed rules that would explicitly bar providers of gender-affirming care from participating in Medicare and Medicaid and prohibit Medicaid payments for transgender health services. Those rules have not yet taken effect, and HHS is accepting public comments until February 17.
In their complaint, the attorneys general assert that HHS is attempting to use the declaration to circumvent legal requirements and enact immediate, nationwide consequences. They warn that the move creates uncertainty for transgender youth and their families, who fear disruption of ongoing care, and places doctors and hospitals in an untenable position—forced to choose between adhering to evidence-based medical practices and maintaining their participation in federal health programs.
The coalition further argues that the federal government’s action infringes on states’ long-standing authority to regulate medicine. They contend that the threat to disqualify providers who offer gender-affirming care would undermine state Medicaid programs, which millions of Americans rely on for essential health services, and could exacerbate existing provider shortages.
“By attempting to impose a single nationwide standard and threatening to punish providers who adhere to well-established, evidence-based care, HHS is unlawfully interfering in decisions that should be made by doctors and their patients,” the attorneys general said in a joint statement.
The lawsuit asks the court to declare the HHS directive unlawful and block its enforcement.
Joining Tong in the lawsuit are the attorneys general of California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Rhode Island, Vermont, Wisconsin, and the District of Columbia, as well as the governor of Pennsylvania.