AG Rayfield Leads 22 States Blocking HHS Threats to Providers
Summary
Attorney General Dan Rayfield led a coalition of 22 states in securing a federal court order blocking a December 18, 2025 declaration by HHS Secretary Kennedy asserting that certain forms of gender-affirming care are 'unsafe and ineffective.' The declaration had attempted to give HHS power to exclude healthcare providers from Medicare and Medicaid programs for providing care to transgender adolescents. The U.S. District Court for the District of Oregon granted the plaintiff states' summary judgment motion, issuing a written opinion and judgment that block the federal government's threats and protect healthcare providers and hospitals.
Healthcare providers offering gender-affirming care to adolescents who have faced or may face HHS scrutiny should preserve documentation of this ruling, as the court's finding that HHS lacked statutory authority to issue the declaration and failed required rulemaking procedures creates a potential defense in any future exclusion attempts. The 22-state coalition structure may serve as a model for coordinated state-level responses to federal agency overreach in healthcare policy.
What changed
The court issued a final written opinion and judgment granting summary judgment to the plaintiff states, blocking HHS's December 2025 declaration that certain gender-affirming care for youth with gender dysphoria is 'unsafe and ineffective.' The declaration had sought to give Secretary Kennedy authority to exclude healthcare providers from Medicare and Medicaid programs for providing care to transgender adolescents. The court agreed with the states that Secretary Kennedy lacked legal authority, that HHS's actions were arbitrary and capricious, and that the agency failed to follow notice-and-comment rulemaking requirements.
Healthcare providers and hospitals that offer gender-affirming care to adolescents are protected from HHS threats of program exclusion under this ruling. Providers in the 22 plaintiff states—or any provider nationwide facing similar federal pressure—may cite this ruling as precedent that HHS lacks authority to condition Medicare and Medicaid participation on abandoning evidence-based care practices. The court's procedural holding on the failure to conduct notice-and-comment rulemaking has implications for future HHS regulatory actions.
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Attorney General Rayfield Wins Lawsuit Protecting Gender-Affirming Care
April 20, 2026 • Posted in Homepage, Lawsuits and Letters, Media Release
Update: Court Issues Final Written Order
Attorney General Dan Rayfield led a coalition of 22 states today in securing a federal court order blocking an unlawful attempt by the Trump Administration to threaten healthcare providers that provide care for youth with gender dysphoria. A federal district court issued a written opinion and judgment, granting the plaintiff states’ summary judgment motion.
“When families and doctors make healthcare decisions together, no federal official should be able to use threats and intimidation to get in the way,” said Attorney General Rayfield. “That’s what Secretary Kennedy tried to do – force hospitals and providers to abandon their patients. Oregon will always stand up for the dignity and wellbeing of every person.”
On December 18, 2025, the U.S. Department of Health and Human Services (HHS) issued a declaration asserting that certain forms of gender-affirming care are “unsafe and ineffective.” In the declaration, Secretary Kennedy attempted to give HHS the power to exclude healthcare providers from Medicare and Medicaid programs simply for providing care for transgender adolescents.
Attorney General Rayfield and the coalition immediately sued in the U.S. District Court for the District of Oregon, arguing that Secretary Kennedy lacked the legal authority to issue the declaration; that HHS’s actions were arbitrary and capricious; and that the agency failed to adhere to the necessary procedural requirements for notice-and-comment rulemaking.
At the end of a summary judgment hearing last month, a federal judge agreed with the states and issued an oral ruling blocking the federal government’s threats. Today’s written opinion and judgment effectuate that prior ruling and protect healthcare providers and hospitals from the potentially destabilizing effects of HHS’s unlawful actions.
Joining Attorney General Rayfield in this lawsuit are the attorneys general of California, Colorado, Connecticut, Delaware, the District of Columbia, Hawai’i, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Rhode Island, Vermont, Washington, Wisconsin, and the governor of Pennsylvania.
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