On September 2, 2026, twenty-two states and the District of Columbia filed suit against the Department of Health and Human Services and the Centers for Medicare & Medicaid Services in the U.S. District Court for the District of Massachusetts, Civil Action No. 26-cv-14051. The complaint challenges CMS-2451-F, the August 2026 final rule ending Medicaid and CHIP payment for gender-transition procedures on minors.
The states claim the rule exceeds CMS's statutory authority, violates the Administrative Procedure Act and the Spending Clause, and conflicts with Medicaid requirements.
As of today no injunction has been entered and no court has ruled on the merits. The rule remains scheduled to take effect October 13, 2026. This case is separate from the pending California and Oregon litigation over essential health benefits.