The U.S. government has put its enforcement plans on hold for now, agreeing not to push hospitals or clinics out of Medicare or Medicaid over gender-affirming care for minors while a major court challenge moves forward.
According to a recent court filing, the Department of Health and Human Services will refrain from issuing exclusion notices to providers until a judge rules on the case—or for at least 30 days after any hearing on the merits. The pause comes amid a legal battle brought by a coalition of Democratic-led states that argue the administration overstepped its authority.
The dispute centers on proposed federal rules introduced last month that would sharply restrict access to gender-affirming care for children. Those rules would bar hospitals offering such care from participating in Medicare and Medicaid, and would also block Medicaid and the Children’s Health Insurance Program from covering related treatments.
The proposal marked one of the administration’s most far-reaching moves affecting transgender healthcare, part of a broader effort to roll back protections across areas ranging from healthcare and education to employment and military service.
When unveiling the rules, HHS leadership said the department concluded that gender-affirming care for minors did not meet healthcare standards—a claim at odds with positions long held by major U.S. medical organizations.
States challenging the policy argue that the federal government is attempting to rewrite medical standards by regulation, pressure healthcare providers into compliance, and intrude on state authority over the practice of medicine. Their lawsuit is being heard in federal court in Oregon.
Under the agreed briefing schedule, the government is expected to file its response and any counter-arguments by February 10. The states must reply by March 3, with a final round of submissions due later in March.
Advocates say the temporary standstill offers breathing room. The agreement, they argue, brings a measure of certainty for families, patients, and hospitals—at least until the court weighs in on whether the proposed restrictions can stand.
