Office of the
Illinois Attorney General
Kwame Raoul

Chicago – Attorney General Kwame Raoul lead a coalition of 20 attorneys general, in submitting comment letters opposing two proposed rules by the United States Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) that would prevent hospitals and medical providers from providing, and youth from receiving, essential transgender healthcare by threatening to withhold funds through the Medicare and Medicaid programs. 

“These proposed rules are the Trump administration’s latest attempt to undermine the essential rights of youth living with gender dysphoria across the nation, including in states like Illinois that has enacted robust laws to protect their right to receive clinically prescribed healthcare,” Raoul said. “These rules greatly exceed the administration’s authority because no federal agency has the power to directly regulate healthcare—a traditional and congressionally recognized power reserved for the states. I will continue to push back on these unlawful policy changes and efforts by the federal government to upset the balance of power between states and the federal government.” 

In December 2025, CMS proposed two rules that, if implemented, would bar hospitals from providing medically necessary transgender healthcare to youth by withholding Medicaid and Medicare funds to any hospitals that continue to provide such care and prohibiting state Medicaid and Children’s Health Insurance Program (CHIP) plans from using federal funding for medically necessary transgender youth healthcare. 

The proposed Medicaid reimbursement rule would deprive states of their congressionally authorized role as Medicaid administrators and the proposed hospital conditions of participation rule would strip public and private hospitals in Illinois of vital Medicare and Medicaid hospital funding for all healthcare, solely because a hospital offers some individuals transgender youth healthcare. Raoul and the coalition explain CMS and the federal government lack the power to deprive states of their longstanding duty to regulate the practice of medicine in ways that ensure access to medically necessary healthcare for the safety and well-being of their residents. 

Raoul and the coalition assert in their comment letters that the proposed rules intrude on the states’ rights to regulate medicine within their borders, violate the Spending Clause and Equal Protection Clause, and contradict various statutes including the Social Security Act, the Affordable Care Act, the Administrative Procedure Act, and vital nondiscrimination laws. The proposed rules further reflect HHS’s decision to discriminate against transgender youth despite contrary medical and scientific evidence, as shown by the agency’s failure to faithfully engage in the rulemaking process, including its lack of required regulatory impact and flexibility analyses. 

For example, the letters explain that CMS attempts to support the rules by referencing its own commissioned HHS report, without addressing medical and scientific evidence unfavorable to its position. However, the HHS report has been discredited as methodologically flawed because it was anonymously published without peer review and issued at the direction of the president to support his goal of ending transgender health care. Additionally, the proposed rules will bear significant costs to transgender youth, their families and their healthcare providers, which HHS does not account for. 

Joining Raoul in sending both these letters are the attorneys general of Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont, Washington and Wisconsin.