Overview
- A coalition of 19 states and Washington, D.C., filed suit on Dec. 23 in the U.S. District Court for the District of Oregon seeking to block and vacate the HHS declaration as unlawful under the Administrative Procedure Act and Medicare and Medicaid statutes.
- HHS said General Counsel Mike Stuart referred Seattle Children’s Hospital to the department’s Office of Inspector General for investigation over alleged failure to meet professionally recognized standards of care referenced in the declaration.
- The Dec. 18 declaration states HHS may bar providers from Medicare, Medicaid, and other federal programs if they offer certain interventions for gender dysphoria to minors, citing an HHS report that favors behavioral therapy.
- Plaintiffs argue the agency lacks authority to change medical standards or threaten funding without statutory backing and required notice-and-comment rulemaking, naming HHS, Secretary Kennedy, the OIG, and Inspector General Thomas March Bell as defendants.
- Hospitals have reported operational effects in 2025, with some scaling back youth programs in response to federal pressure, raising concerns about patient access and financial risk.