September 3, 2026 - OAKLAND — California Attorney General Rob Bonta on Wednesday co-led a coalition of 21 attorneys general and one governor in filing a lawsuit challenging a rule by the U.S. Department of Health and Human Services (HHS) that would prohibit federal reimbursement for gender-affirming care for adolescents in Medicaid and the Children’s Health Insurance Program (CHIP). In the lawsuit, Attorney General Bonta argues that the rule oversteps HHS’s legal authority, lacks or misuses evidence to justify its added restrictions, and violates the law and long lasting precedent by blocking reimbursements for medically necessary care. The rule will be effective on October 13, 2026, unless the court intervenes. 

“HHS has disregarded the law and its own policy precedent in another attempt to restrict transgender individuals’ access to crucial care,” said Attorney General Bonta. “We will not stand by as the Trump Administration oversteps its authority and twists the facts to justify its bad-faith agenda against transgender Americans. We will continue to fight to secure access to medically necessary care and protect transgender individuals’ abilities to prosper as their authentic selves.” 

On December 18, 2025, HHS announced two proposed rules regarding gender-affirming care. The rule that is the subject of this lawsuit would stop Medicaid and CHIP from reimbursing for medically necessary gender-affirming care for anyone under the age of 18 under Medicaid and under the age of 19 under CHIP.  

In this lawsuit, Attorney General Bonta and the coalition ask the U.S. District Court for the District of Massachusetts to declare the final rule unlawful and block HHS from implementing or enforcing the rule. In the lawsuit, Attorney General Bonta argues:

• The final rule oversteps HHS’s legal authority and violates separation of powers regulations by seeking to regulate the practice of medicine, a responsibility that has been reserved for states by Congress and legal precedent.
• The final rule fails to adequately justify a categorical ban on gender-affirming care for individuals under the age of 18 or 19. HHS cherry-picked evidence to support its arguments and did not properly consider evidence demonstrating the health benefits of gender-affirming care.
• The final rule excludes care for transgender adolescents that states have deemed medically necessary from coverage, which violates the Social Security Act and longstanding HHS precedent.
• HHS lacks the authority to prohibit Medicaid or CHIP from covering essential medical services that are provided in compliance with state laws.

Even if the final rule goes into effect, providers can still legally offer gender-affirming care in California. Federal law does not prohibit medical professionals from providing gender-affirming care to patients under the age of 19, and gender-affirming care for minors (and adults) is legal in California. The final rule does not prevent any provider from providing gender-affirming care or penalize them for the provision of gender-affirming care. The final rule expressly allows states to cover gender-affirming care using state-only funds.

Attorney General Bonta continues to stand firmly in support of healthcare policies that respect the dignity and rights of all people and has worked tirelessly to protect the LGBTQ+ community against unlawful threats from the Trump Administration. In April 2026, he secured a ruling blocking HHS Secretary Robert F. Kennedy, Jr.’s declaration claiming gender-affirming care fails to meet professionally recognized standards of care and that HHS may disqualify providers of such care from programs like Medicare and Medicaid. Under that ruling, HHS, including HHS’s Office of Inspector General, may not initiate enforcement action or exclude any provider or hospital for providing gender-affirming care in a manner and quality consistent with the professionally recognized standards of care in the doctor’s or hospital’s state.

Attorney General Bonta co-led the filing of today’s lawsuit alongside Illinois Attorney General Kwame Raoul, Maryland Attorney General Anthony Brown, Connecticut Attorney General William Tong, and Massachusetts Attorney General Andrea Joy Campbell. They are joined by the attorneys general of Colorado, Delaware, the District of Columbia, Hawaii, Maine, Michigan, Minnesota, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont, Virginia, Washington, and Wisconsin, as well as the Governor of Pennsylvania.

Source: CA. DOJ