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BALTIMORE, MD – Attorney General Anthony G. Brown today joined a multistate coalition 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 access to gender-affirming care for young people.
On December 18, HHS published a document that the agency called a “declaration," falsely claiming that certain forms of gender-affirming care are “unsafe and ineffective" and threatening to punish any doctors, hospitals, and clinics that continue to provide it with exclusion from the federal Medicare and Medicaid programs. Attorney General Brown and the coalition argue that this declaration violates federal statutes by unlawfully changing medical standards without going through the notice and comment process and undermining states' long-standing authority to regulate medicine. The coalition is asking the court to intervene and set aside the unlawful and arbitrary declaration.
“Healthcare decisions should be made by doctors and patients—not by politicians in Washington threatening to destroy providers' careers and spreading fear among transgender youth and their families," said Attorney General Brown. “This isn't just about following the law—though HHS is clearly violating it. This is about protecting vulnerable young people who deserve the same dignity, respect, and access to medical care as anyone else. We're standing up against this cruel and unlawful action because every Marylander, regardless of who they are, deserves compassionate, evidence-based healthcare from providers who won't be punished for doing what's right."
In the declaration, HHS Secretary Robert F. Kennedy, Jr. claimed to give HHS the power to exclude healthcare providers and institutions from the Medicare and Medicaid programs simply for providing gender-affirming 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 gender-affirming 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 Brown 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 healthcare 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. For generations, states, not the federal government, have been responsible for regulating the practice of medicine. 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.
The coalition warns that HHS will attempt to use this unlawful action to impose immediate and widespread consequences. 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.
Attorney General Brown and the coalition are asking the court to rule the HHS declaration unlawful and block its enforcement.
Joining Attorney General Brown in this lawsuit are the attorneys general of California, Colorado, Connecticut, the District of Columbia, Delaware, Illinois, Maine, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, and Wisconsin, as well as the Governor of the Commonwealth of Pennsylvania.
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