Oregon Sues HHS Over Directive Targeting Gender-Affirming Care for Teens
In a lawsuit filed yesterday, Oregon led a coalition of 18 other states and the District of Columbia against Secretary Kennedy of the U.S. Department of Health and Human Services (HHS), who unlawfully attempted to limit a family’s ability to work with their preferred providers to make healthcare decisions without federal government interference in a controversial directive.
Oregon Opposed Gender-Affirming Care Federal Directive In Court
Oregon Attorney General Dan Rayfield filed the lawsuit in the U.S. District Court (Oregon), seeking to block the December 18 HHS directive that unlawfully interferes with gender-affirming care. HHS published a “declaration,” claiming that certain forms of gender-affirming care are “unsafe and ineffective.”
Source: Oregon DOJ media release (Dec 24, 2025) and Federal Register proposed rules (Dec 19, 2025, documents 2025-23464 and 2025-23465)
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Secretary Kennedy said in the “declaration” that HHS can exclude health care providers and institutions from the Medicare and Medicaid programs simply for providing health care for transgender adolescents.
The document was an attempt to change the rules and make them effective nationwide immediately, without consulting doctors, patients, or states. Secretary Kennedy proposed two rules:
- A complete bar of gender-affirming care providers and associated hospitals from participating in Medicare and Medicaid.
- A ban on 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.
The coalition argues that HHS is attempting to use the declaration to circumvent basic legal requirements for policy changes. They contend that this is a clear overreach by the federal government, as HHS lacks the authority to take such an action.
The coalition is asking the court to rule the HHS declaration unlawful and block its enforcement.
Oregon Gender Affirming Care Regulated By Statute
In Oregon, gender-affirming care is protected under HB 2002, passed in 2023. Health insurers are required to cover medically necessary treatments, protecting both patients and providers from out-of-state legal challenges.
| Topic | Federal action (proposed) | Oregon baseline (today) |
|---|---|---|
| Medicare and Medicaid participation | Hospitals could be barred from program participation based on care provided to minors | Medical practice oversight runs through state licensing and discipline (Oregon Medical Board) |
| Medicaid and CHIP payments | Federal funding rules would restrict payment through Medicaid and CHIP for minors | Oregon sets coverage rules for plans in state, including protections under HB 2002 |
| Insurance coverage in Oregon | Indirect pressure by threatening provider participation in federal programs | HB 2002 requires coverage of medically necessary gender affirming care |
| Complaints and discipline | Federal lever is funding and participation penalties | Oregon Medical Board investigates complaints and can impose discipline |
The Bill ensures coverage for procedures including surgeries, hormone therapy, and revisions to prior treatments.
The Oregon Medical Board regulates doctors and medical care day to day (licensing, complaints, discipline). The lawsuit argues that the federal government should not override that by using Medicare and Medicaid threats as a backdoor ban.
If the Board believes a violation occurred, it can issue a “Complaint and Notice of Proposed Disciplinary Action” and act against health care providers. The Board’s outcomes can include a stipulated order with terms like ‘suspension, fine, probation, reprimand.