New York, along with 20 other states and Washington, D.C., asked a federal judge on Wednesday to block a new Trump administration rule that would prevent federal funds from being used to cover gender-affirming care for trans youth under Medicaid and the Children’s Health Insurance Program.
The lawsuit, filed in U.S. District Court in Massachusetts, argues the policy creates illegal barriers to care for low-income New Yorkers covered by the public insurance programs, who may not otherwise be able to afford services such as hormone therapy or puberty blockers.
States still have the option of continuing to cover that care using only state dollars, but the lawsuit contends the new policy would impose a significant financial burden on states that opt to do so. It’s still unclear whether New York will continue covering these services for young people enrolled in these programs if the federal rule is upheld.
“This unlawful rule threatens access to health care for transgender young people and undermines states’ ability to administer our own Medicaid programs,” New York Attorney General Letitia James said in a statement on the lawsuit.
The federal Centers for Medicare and Medicaid Services finalized new rules last month barring Medicaid from covering services such as hormone therapy and puberty blockers — which the agency refers to as “sex-rejecting” procedures — for patients under 18 and barring CHIP from covering such services for patients under 19. The policy change is set to take effect on Oct. 13 but allows for up to six months of additional coverage for patients on hormone therapy to allow for a “tapering-off period.”
The policy change is the Trump administration’s latest attempt to restrict access to youth gender-affirming care. The federal government proposed rules earlier this year that would block hospitals from receiving federal Medicare or Medicaid funding if they provide services such as hormone therapy or puberty blockers to minors, though the rules were never finalized.
The U.S. Department of Justice has also issued subpoenas seeking the medical records of trans youth served at NYC hospitals, though those have so far been blocked in court.
Nonetheless, NYU Langone Health and Mount Sinai Health System both discontinued gender-affirming care for minors earlier this year.
“Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits,” Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz said of the new Medicaid and CHIP rules.
Professional medical organizations such as the American Academy of Pediatrics have said that procedures such as hormone therapy and puberty blockers are legitimate treatments for gender dysphoria in young people.
If the federal rule remains in place, it’s unclear whether young, low-income New Yorkers will be able to access gender-affirming care using Medicaid or CHIP come fall.
The state Department of Health is still considering the implications of the new policy and determining how to respond, said Cadence Acquaviva, a spokesperson for the agency. It isn’t clear how many New Yorkers are potentially affected by the rule change.
Acquaviva added that the health department is “closely monitoring the chilling effect federal actions are having on gender-affirming care in New York.”
When the federal policy change was announced last month, Planned Parenthood of Greater New York called on the Hochul administration to ensure that there was still funding for youth gender-affirming care, even if federal dollars stopped flowing.
“At a moment when transgender people and their health care are under relentless attack, we expect the State to use every tool available to ensure that care remains protected, funded, and accessible to everyone who needs it,” Robin Chappelle Golston, the president and CEO of Planned Parenthood of Greater New York, said at the time.
An estimated 37,000 New Yorkers between the ages of 13 and 17 identify as transgender, accounting for about 3% of the state’s adolescents, according to the Williams Institute, a UCLA research center on sexual and gender identity and public policy. But not all of those adolescents receive gender-affirming care, and not all who do have it covered by public insurance programs.