Washington joins coalition challenging federal attack on gender-affirming healthcare for youth
The federal administration is unlawfully attempting to block states from using federal Medicaid funds for gender-affirming care for low-income minors and some young adults, according to allegations in a new lawsuit filed by Washington, 20 other states, and the District of Columbia today.
The coalition argues that since the creation of Medicaid and the Children’s Health Insurance Program (CHIP) in the 1960s, Congress has always granted states the authority to determine which services would be covered under their Medicaid and CHIP programs, subject only to limits set by statute.
The coalition asserts that the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) are now acting without statutory authority or a reasoned basis to second-guess state Medicaid agencies’ reliance on individualized medical necessity and treatment decisions made by healthcare providers. Instead, based solely on CMS’s unilateral decision-making, the agencies are categorically excluding medically necessary healthcare services from federal reimbursement only when provided to low-income transgender adolescents.
“The federal administration is once again claiming powers it does not have—this time, in order to foreclose healthcare options that should be left to Washington youth, their doctors, and their families,” Attorney General Nick Brown said. “We will continue fighting to protect the Medicaid and CHIP programs from unlawful federal overreach.”
In December 2025, HHS proposed a rule prohibiting federal reimbursement for gender-affirming care for Medicaid beneficiaries under age 18 and CHIP beneficiaries under age 19, despite covering the same healthcare treatment when provided to non-transgender youth. HHS received more than 30,000 comments on the proposal. More than 90% of the comments, including comments from Brown and a coalition of state attorneys general, opposed the rule. Despite this strong opposition, the broad medical consensus on the safety and efficacy of transgender youth healthcare, and strong state law guardrails to ensure high-quality care, HHS finalized the rule earlier this month, with an effective date of Oct. 13.
If HHS and CMS proceed with the change, the state of Washington would have to pay about $1 million annually to cover the portion of Medicaid and CHIP costs previously covered by the federal government.
In their complaint, the coalition argues the rule would set an unlawful precedent that the executive branch can, without congressional authorization, replace individualized judgments made by licensed medical practitioners with a categorical prohibition on reimbursement for healthcare it disfavors.
The coalition argues the rule runs counter to several federal and state laws. They also assert the rule violates the Administrative Procedure Act and the Spending Clause of the U.S. Constitution.
Since the first day of President Trump’s second term, the administration has launched relentless attacks on this minority in nearly every aspect of their lives, but especially in healthcare. Washington has sued the federal administration several times to challenge efforts to restrict gender-affirming care, including in February 2025 and in December 2025. For a full list of Washington’s lawsuits defending Washingtonians’ rights from attacks by the current federal administration and protecting federal funding for our state, see our Federal Litigation Tracker.
Joining Brown 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, Oregon, Rhode Island, Vermont, Virginia, and Wisconsin, along with the governor of Pennsylvania.
-30-
Washington’s Attorney General serves the people and the state of Washington. As the state’s largest law firm, the Attorney General’s Office provides legal representation to every state agency, board, and commission in Washington. Additionally, the Office serves the people directly by enforcing consumer protection, civil rights, and environmental protection laws. The Office also prosecutes elder abuse, Medicaid fraud, and handles sexually violent predator cases in 38 of Washington’s 39 counties. Visit www.atg.wa.gov to learn more.
Media Contact:
Email: press@atg.wa.gov
Phone: (360) 753-2727
General contacts: Click here
Legal Disclaimer:
EIN Presswire provides this news content "as is" without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.
