A federal judge in Oregon on Monday issued an order barring the U.S. Department of Health and Human Services from implementing gender-treatment restrictions in 21 states and the District of Columbia.
Last December, HHS issued a declaration that certain forms of gender-treatment care are "unsafe and ineffective." In the declaration, Secretary Robert F. Kennedy Jr. attempted to give HHS the power to exclude health care providers from Medicare and Medicaid programs if they provided care for transgender adolescents. The plaintiffs challenged the declaration in a lawsuit.
In a written opinion, Judge Mustafa Kasubhai of the U.S. District Court for the District of Oregon referenced the administration's "significant and troubling history of evading or flouting prior court orders." He characterized Kennedy's declaration as a nonbinding personal opinion with no legal consequences.
"Citing the Kennedy declaration, defendants have exploited the threat of exclusion to bully health care providers into suspending gender-affirming care they would otherwise provide in compliance with statewide standards of care out of fear they will lose federal health care program funding and the attendant ability to provide any lifesaving care to all children," he wrote in his opinion.
The plaintiffs hailed the ruling.
"When families and doctors make health care decisions together, no federal official should be able to use threats and intimidation to get in the way," Oregon Attorney General Dan Rayfield said. "That's what Secretary Kennedy tried to do -- force hospitals and providers to abandon their patients. Oregon will always stand up for the dignity and wellbeing of every person."
Massachusetts Attorney General Andrea Joy Campbell agreed.
"This ruling is a decisive rejection of the federal government's attempt to intimidate providers and deny young people access to medically necessary, lifesaving care," she said. ""The harm from these threats is already being felt, including here in Massachusetts where some providers have scaled back or declined to offer care out of fear of federal retaliation. This decision helps protect providers and affirms that medical decisions belong with patients, their families and their doctors – not the federal government."
The written order blocks HHS from enforcing the declaration or any materially similar policy against the hospitals in jurisdictions that filed the lawsuit -- Oregon, Washington, New York, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Pennsylvania, Rhode Island, Vermont and Wisconsin and the District of Columbia.
The ruling removes one layer of legal risk for hospitals operating in states where gender care remains legal at the state level
"However, it does not resolve the broader regulatory uncertainty entirely," Becker's Hospital Review reported. "The injunction does not apply to health care organizations in the remaining 29 states, nor does it address the separate proposed CMS rules that would end Medicare and Medicaid payments to hospitals providing gender-affirming care to minors. These proposed rules remain a pending threat for health care providers regardless of where they operate."
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