On August 13, 2026, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule categorically prohibiting insurance coverage for evidence-based treatments for gender dysphoria for all youth enrolled in Medicaid (under age 18) and the Children’s Health Insurance Program (“CHIP”) (under age 19). That applies to puberty-delaying medications, hormone therapy, and surgical interventions. As a result, working families across the United States will be left with an impossible choice of paying thousands for out-of-pocket expenses or risk their child’s symptoms of gender dysphoria worsening,  including psychological crisis and self-harm.  

At the start of October, NCLR, along with GLAD Law, ACLU of New Hampshire, and Robinson & Cole LLP, filed a challenge to the new rule on behalf of four New Hampshire families that risk losing access to essential care for their transgender child. Our claims are twofold. First, the final CMS rule violates the Administrative Procedures Act (APA) for arbitrarily denying benefits to qualified families based on a diagnosis and because CMS lacks the authority to categorically ban a diagnosis from coverage without considering medical necessity. Second, the rule also violates the Fifth Amendment Due Process Clause for being motivated solely by animus towards transgender people, as much of this administration’s attacks. 

Our plaintiffs are seeking to preliminarily enjoin the enforcement of the CMS rule as the lawsuit moves forward. A hearing will be held October 30, 2026, on the Motion for Preliminary Injunction.