21 Attorneys General and Pennsylvania's Governor Sue HHS to Block the Medicaid and CHIP Ban on Gender-Affirming Care for Minors

On Sept. 2, 2026, a coalition led by California Attorney General Rob Bonta - 21 attorneys general plus the governor of Pennsylvania - filed a 60-page lawsuit in the U.S. District Court for the District of Massachusetts challenging a final HHS rule that bars federal Medicaid reimbursement for puberty-delaying medication, hormone therapy and surgery to treat gender dysphoria for anyone under 18, and under 19 for the Children's Health Insurance Program. The rule, issued by the Centers for Medicare & Medicaid Services, was finalized on Aug. 13 after HHS received more than 30,000 public comments, over 90 percent of them opposed, and takes effect Oct. 13, 2026.

The states argue the rule exceeds HHS's statutory authority, replaces individualized medical judgments with a categorical federal prohibition, and strips states of the role Congress gave them in administering Medicaid and CHIP. The same treatments remain reimbursable for other diagnoses, which the states say shows the restriction targets a population rather than a treatment.

Defendants include HHS, Secretary Robert F. Kennedy Jr., CMS and Administrator Mehmet Oz. HHS declined to comment on pending litigation. No court has ruled; the states ask that the rule be declared unlawful and blocked before it takes effect.