Attorney General Neronha, coalition file lawsuit challenging federal attack on gender-affirming care
PROVIDENCE, R.I. – Attorney General Peter F. Neronha joined a multistate coalition of 18 other states and the District of Columbia in challenging a recent attempt by U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. to threaten health care providers and unlawfully limit access to gender-affirming care for young people.
A recent declaration release by HHS, which falsely claims that certain forms of gender-affirming care are “unsafe and ineffective,” threatens to punish any doctors, hospitals, and clinics that continue to provide this health care with the threat of exclusion from federal Medicare and Medicaid programs.
As alleged in the complaint, this declaration violates federal statutes by unlawfully changing medical standards, fails to go through notice and comment processes, and ultimately undermines states’ long-standing authority to regulate medicine. The coalition asks the court to rule the HHS declaration unlawful and block its enforcement.
On December 18, HHS issued a “declaration” in which the agency claimed that certain forms of gender-affirming care are “unsafe and ineffective.” In the “declaration,” Secretary Kennedy asserts that HHS may exclude health care providers and institutions from the Medicare and Medicaid programs simply for providing gender-affirming health care for transgender youth. The agency also announced two proposed federal rules that would completely bar hospitals that provide gender-affirming care to individuals under the age of 18 from participating in Medicare and Medicaid, and ban Medicaid payments for gender-affirming health care provided to individuals under the age of 19. These rules have not yet gone into effect, and HHS has given the public until February 17, 2026, to submit comments on the proposals.
The coalition argues that HHS is attempting to use the “declaration” to circumvent basic legal requirements for policy changes. Federal law requires agencies to provide the public with notice and an opportunity to comment before making significant changes to health care policy. Instead, HHS issued what it arbitrarily called a declaration and attempted to make it effective nationwide immediately, without consulting doctors, patients, or states. The coalition contends that this is a clear overreach by the federal government, given that HHS does not have the authority to take such an action. For generations, states, not the federal government, have been responsible for regulating the practice of medicine. The “declaration” also directly conflicts with Rhode Island state law, which requires state-licensed entities to “operate on a nondiscriminatory basis” including on the basis of “gender identity or expression.” 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 coalition warns that HHS will attempt to use this unlawful action to enact immediate and widespread consequences. For transgender youth and their families, it creates fear and uncertainty about whether ongoing health care could suddenly be taken away. For doctors and hospitals, it threatens severe penalties simply for treating their patients with evidence-based, medically necessary care. For states, it puts Medicaid programs at risk – programs that millions of people depend on for everyday and lifesaving care. States rely on broad networks of providers to deliver essential health services. By threatening to disqualify providers who offer gender-affirming care, the federal government is forcing doctors to choose between abandoning their patients or risking their livelihoods. This pressure would reduce access to care, worsen provider shortages, and harm Medicaid patients far beyond those seeking gender-affirming care.
Joining Attorney General Neronha in this lawsuit are the attorneys general of California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Oregon, Vermont, Washington, Wisconsin, and the District of Columbia, as well as the governor of Pennsylvania.
