Attorney General Dan Rayfield sued the Trump administration today over its attempt to block states from using federal Medicaid dollars to pay for gender-affirming care for low-income kids and young adults.
“Freedom means very little if the government can reach into your family’s private decisions and take it away,” said Attorney General Rayfield. “Our office will continue to do everything we can to defend the right to keep these medical choices between patients, families and their doctors.”
In the lawsuit, AG Rayfield and a coalition of 22 states point out something simple: since Medicaid and the Children’s Health Insurance Program (CHIP) were created in the 1960s, states – not the federal government – have had the authority to decide what’s covered, within the limits Congress set. Now, the coalition argues, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) are ignoring that history. They’re overriding doctors’ medical judgment and state Medicaid programs’ own decisions, based on nothing more than their own say-so – and they’re doing it only for low-income transgender adolescents, while continuing to cover the exact same care for everyone else.
In December 2025, HHS proposed cutting off federal reimbursement for gender-affirming care for Medicaid patients under 18 and CHIP patients under 19 – even though the same treatments remain covered for other youth. The agency received more than 30,000 public comments, and over 90% opposed the rule, including comments from AG Rayfield and a coalition of state attorneys general. HHS finalized it anyway earlier this month. It’s set to take effect on Oct. 13, 2026.
The coalition argues the rule sets a dangerous precedent: that the executive branch can simply override doctors’ individual medical judgment and replace it with a blanket, agency-imposed ban on care it doesn’t like – without Congress ever weighing in.
Since the first day of President Trump’s second term, the administration has launched relentless attacks on this small and vulnerable population in nearly every aspect of their lives, but especially in healthcare. Attorney General Rayfield has repeatedly pushed back. This is AG Rayfield’s third lawsuit over federal attacks on gender affirming care. Courts have already sided with the states twice: in March of 2026, blocking HHS from cutting off hospitals from Medicare and Medicaid over the care, and in August of 2026, striking down a rule that stripped it from the ACA’s essential health benefits. In Oregon, this care is also protected under state law.
Alongside Attorney General Rayfield in filing today’s lawsuit are the attorneys general of California, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Michigan, Minnesota, Maryland, Massachusetts, Nevada, New Jersey, New York, Rhode Island, Vermont, Virginia, Washington, and Wisconsin, along with the governor of Pennsylvania.
