ATTORNEY GENERAL BROWN JOINS COALITION CHALLENGING TRUMP ADMINISTRATION'S LATEST ATTACK ON HEALTHCARE FOR TRANSGENDER YOUTH

The following information was released by the Maryland Attorney General:

Attorney General Anthony G. Brown joined a coalition of 22 states in challenging the Trump administration's attempt to prohibit states from using federal Medicaid funds for gender-affirming care for low-income minors and some young adults.

In its lawsuit, the coalition argues that since the creation of the Medicaid and Children's Health Insurance Program (CHIP) programs in the 1960s, Congress has always granted states the authority to determine which services would be covered under their Medicaid and CHIP programs, subject only to limits set by statute. The coalition asserts that the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) are now acting without statutory authority or a reasoned basis to second-guess state Medicaid agencies' reliance on individualized medical necessity and treatment decisions made by healthcare providers. Instead, based solely on CMS's unilateral decision making, the federal agencies are categorically excluding medically necessary healthcare services from federal reimbursement only when provided to low-income transgender adolescents.

"Every young Marylander deserves medical care recommended by their healthcare provider, not dictated by politics," said Attorney General Brown. "We are taking action today to defend the health and dignity of transgender youth and the providers who care for them."

In December 2025, HHS proposed a rule prohibiting federal reimbursement for gender-affirming care for Medicaid beneficiaries under age 18 and CHIP beneficiaries under age 19, despite covering the same healthcare treatment when provided to non-transgender youth. HHS received more than 30,000 comments on the proposal. More than 90% of the comments, including comments from Attorney General Brown and a coalition of state attorneys general, opposed the rule. Despite this strong opposition, the broad medical consensus on the safety and efficacy of transgender youth healthcare, and strong state law guardrails to ensure high-quality care, HHS finalized the rule earlier this month, with an effective date of October 13, 2026.

In their complaint, Attorney General Brown and the coalition argue that the rule would set a troubling and unlawful precedent that the executive branch can, without congressional authorization, replace individualized judgments made by licensed medical practitioners with a categorical, agency-determined prohibition on reimbursement for healthcare it disfavors.

The coalition argues that the rule runs counter to several federal and state laws. They also assert that the rule violates the Administrative Procedure Act and the Spending Clause of the U.S. Constitution.

Since the first day of President Trump's second term, the administration has launched relentless attacks on this small and vulnerable population in nearly every aspect of their lives, but especially in healthcare. Attorney General Brown has repeatedly stepped in to defend access to that care for Maryland's transgender youth and their families. Alongside coalitions of attorneys general and other state officials, Attorney General Brown challenged federal threats against providers who treat youth with gender dysphoria, fought efforts to strip gender-affirming care from the Affordable Care Act's essential health benefits and cost protections, and spoke out against CMS and HHS rules seeking to strip Medicaid and Medicare funding from hospitals that serve transgender minors.

Joining Attorney General Brown in filing today's lawsuit are the attorneys general of California, Colorado, Connecticut, Delaware, the District of Columbia, Hawai'i, Illinois, Maine, Michigan, Minnesota, Massachusetts, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont, Virginia, Washington, and Wisconsin, along with the governor of Pennsylvania.