Attorney General Peter F. Neronha has joined a coalition of 18 states and the District of Columbia in filing a lawsuit against the U.S. Department of Health and Human Services (HHS) over a recent declaration concerning gender-affirming care for young people.
The lawsuit challenges an HHS declaration issued by Secretary Robert F. Kennedy Jr., which claims that certain forms of gender-affirming care are “unsafe and ineffective.” The declaration threatens to exclude doctors, hospitals, and clinics providing this care from federal Medicare and Medicaid programs.
According to the complaint, the coalition alleges that HHS violated federal statutes by changing medical standards without following required notice and comment procedures. The suit also argues that the declaration undermines states’ authority to regulate medicine. The coalition is asking the court to rule the HHS declaration unlawful and block its enforcement.
On December 18, HHS released its “declaration,” stating that providers offering gender-affirming health care for transgender youth could be excluded from Medicare and Medicaid programs. In addition, HHS announced two proposed rules: one would bar hospitals providing gender-affirming care to individuals under 18 from participating in Medicare and Medicaid; another would ban Medicaid payments for such care provided to those under 19. These proposals have not yet taken effect, with public comments accepted until February 17, 2026.
The coalition contends that HHS is attempting to bypass legal requirements for policy changes by issuing an immediate declaration rather than engaging in public consultation. Federal law requires agencies to provide notice and allow public input before making significant changes to health care policy. The coalition maintains that states traditionally regulate medical practice, not the federal government.
Rhode Island state law requires licensed entities to operate on a nondiscriminatory basis, including regarding “gender identity or expression.” The coalition argues that the HHS action conflicts with this requirement by threatening providers who follow evidence-based standards of care.
The group warns that these actions could create uncertainty for transgender youth and their families about ongoing access to health care, as well as impose severe penalties on doctors and hospitals treating patients according to established medical guidelines. States’ Medicaid programs could also be affected if provider networks shrink due to these federal threats.
Joining Attorney General Neronha in the lawsuit are attorneys general from California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Oregon, Vermont, Washington, Wisconsin; the District of Columbia; and the governor of Pennsylvania.
“By attempting to impose a single nationwide standard and threatening to punish providers who adhere to well-established, evidence-based care, HHS is unlawfully interfering in decisions that should be made by doctors and their patients,” according to the press release.
