22 states sue Trump administration over Medicaid gender-affirming care rule

A coalition of 22 states and the District of Columbia has filed a lawsuit challenging a Trump administration rule that restricts federal funding for gender-affirming care. The rule, finalized by the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS), prohibits states from using federal Medicaid funds for transgender minors under 18 and CHIP funds for those under 19.

The coalition argues that HHS and CMS are acting without statutory authority. They contend that since the inception of Medicaid and CHIP in the 1960s, Congress has granted states the power to determine covered services within statutory limits. The lawsuit asserts that the federal agencies are overriding state authority and medical judgment by categorically excluding specific treatments for low-income transgender youth while continuing to fund the same treatments for non-transgender youth.

State officials, including Michigan Attorney General Dana Nessel and Oregon Attorney General Dan Rayfield, emphasized that medical decisions should remain between patients, families, and healthcare providers rather than being dictated by politicians. The rule was finalized despite receiving over 30,000 public comments, more than 90% of which opposed the restriction.