Attorney General Rayfield Leads Lawsuit Challenging Federal Attack on Gender-Affirming Care

Attorney General Dan Rayfield today led a coalition of 18 other states and the District of Columbia in suing to ensure the Secretary of the U.S. Department of Health and Human Services (HHS) cannot threaten providers with a so-called declaration that baselessly and unlawfully attempts to limit a family's ability to work with their providers to make the healthcare decisions without interference from the federal government. The declaration falsely claims that certain forms of gender-affirming care are "unsafe and ineffective" and threatens to punish any doctors, hospitals, and clinics that continue to provide it with exclusion from the federal Medicare and Medicaid programs.

"By targeting Oregon providers, HHS is putting care at risk and forcing families to choose between their personal health care choices and their doctor's ability to practice," said Attorney General Rayfield. "Healthcare decisions belong with families and their healthcare providers, not the government."

On December 18, HHS published a document the agency called a "declaration," claiming that certain forms of gender-affirming care are "unsafe and ineffective." In the declaration, Secretary Kennedy claimed to give HHS the power to exclude health care providers and institutions from the Medicare and Medicaid programs simply for providing health care for transgender adolescents. The agency also announced two proposed rules that would completely bar gender-affirming care providers and associated hospitals from participating in Medicare and Medicaid and ban payments for transgender health care through Medicaid. These rules have not yet gone into effect, and HHS has given the public until February 17, 2026 to submit comments on the proposals.

Attorney General Rayfield and the coalition argue that HHS is attempting to use the declaration to circumvent basic legal requirements for policy changes. Federal law requires agencies to provide the public with notice and an opportunity to comment before making significant changes to health care policy. Instead, HHS issued what it arbitrarily called a declaration and attempted to make it effective nationwide immediately, without consulting doctors, patients, or states. The attorneys general contend that this is a clear overreach by the federal government, given that HHS does not have the authority to take such an action.

The attorneys general warn that HHS is taking this unlawful action in an attempt to intimidate providers. For transgender youth and their families, it creates fear and uncertainty about whether ongoing care could suddenly be taken away. For doctors and hospitals, it threatens severe penalties simply for treating their patients with evidence-based, medically necessary care. For states, it puts Medicaid programs at risk - programs that millions of people depend on for everyday and lifesaving care. States rely on broad networks of providers to deliver essential health services. By threatening to disqualify providers who offer gender-affirming care, the federal government is forcing doctors to choose between abandoning their patients or risking their livelihoods. This pressure would reduce access to care, worsen provider shortages, and harm Medicaid patients far beyond those seeking gender-affirming care.

In Oregon, gender-affirming care is protected under HB 2002, passed in 2023, which requires health insurance to cover medically necessary treatments, protects both patients and providers from out-of-state legal challenges, and ensures coverage for procedures including surgeries, hormone therapy, and revisions to prior treatments. This law makes clear that Oregon remains a sanctuary for families seeking gender-affirming care, and the state will defend these rights against any federal actions that threaten access.

Attorney General Rayfield and the coalition are asking the court to rule the HHS declaration unlawful and block its enforcement.

Joining Attorney General Rayfield in this lawsuit are the attorneys general of California, Colorado, Connecticut, Delaware, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Rhode Island, Vermont, Washington, Wisconsin, and the governor of Pennsylvania.