Oregon leads 22 states in lawsuit challenging cuts for gender-affirming care
(KTVZ) -- Oregon Attorney General Dan Rayfield led a coalition of 22 states and the District of Columbia in filing a lawsuit Wednesday against the Trump administration over a federal rule restricting health care coverage.
The lawsuit challenges a rule by federal health officials that blocks states from using federal Medicaid and Children's Health Insurance Program funds to pay for gender-affirming care for low-income youth.
Under the rule finalized by the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services, federal reimbursement would be cut off for gender-affirming care for Medicaid patients under age 18 and CHIP patients under age 19.
The coalition contends that since Medicaid and CHIP were established in the 1960s, individual states have held the legal authority to decide which medical services are covered within the limits set by Congress.
HHS originally proposed the restriction in December 2025. The agency received more than 30,000 public comments on the proposal, with more than 90% opposing the rule, including opposition submitted by state attorneys general. HHS finalized the policy earlier this month despite the public feedback.
Oregon Rayfield criticized the policy, emphasizing the protection of personal health care decisions. “Freedom means very little if the government can reach into your family's private decisions and take it away,” Rayfield said. “Our office will continue to do everything we can to defend the right to keep these medical choices between patients, families and their doctors.”
The legal filing argues that federal agencies are overriding medical judgment and state authority by creating an agency-imposed ban on care without congressional authorization. The coalition noted that the rule specifically restricts coverage for low-income transgender adolescents while the federal government continues to fund the exact same medical treatments for other youth. Gender-affirming care also remains protected under Oregon state law.
The lawsuit represents the third legal challenge filed by Rayfield regarding federal actions on gender-affirming care. Federal courts previously ruled in favor of state challenges twice earlier this year. In March 2026, a court blocked HHS from cutting off Medicare and Medicaid funding to hospitals providing the care. In August 2026, a court struck down a rule that removed gender-affirming care from the essential health benefits listed under the Affordable Care Act.
Joining Rayfield in filing the lawsuit are the attorneys general of California, Colo., Conn., Del., Hawaii, Ill., Maine, Md., Mass., Mich., Minn., Nev., N.J., N.Y., R.I., Vt., Va., Wash. and Wisconsin, along with the attorney general of the District of Columbia and the governor of Pennsylvania.
The federal rule is scheduled to take effect Oct. 13, 2026.
