Judge blocks Trump administration from removing Obamacare trans protections
A judge has blocked a rule that would have made it harder for trans people to access gender-affirming care (Getty Images, stock)
A federal judge has struck down a Trump administration rule that would have made it harder for some transgender people to access gender-affirming care through Affordable Care Act insurance plans.
Senior US District Judge Nathaniel Gorton, who was appointed by Republican President George H.W. Bush in 1992, ruled on Friday (14 August) that the Department of Health and Human Services had exceeded its authority when it changed the rules governing which service insurers can classify as “essential health benefits” under Obamacare.
The case was brought by a coalition of 20 states and Pennsylvania Gov. Josh Shapiro last year, who challenged several provisions of the administration’s 2025 Marketplace Integrity and Affordability Final Rule. The states argued that the changes were unlawful and could increase premiums and out-of-pocket costs while causing some people to lose coverage.
One provision would have prevented non-grandfathered individual and small-group insurance plans from treating certain forms of gender-affirming care as essential health benefits beginning in 2026.
As per The Advocate, insurers could still have chosen to cover the care, and individual states could have required coverage. But removing gender-affirming care from the essential-benefits category would have stripped it of important Affordable Care Act protections connected to federal subsidies and patients’ out-of-pocket costs.
Gorton vacated that portion of the rule, although he sided with the Trump administration on four other provisions challenged by the states.
The decision was welcomed by state officials who had challenged the rule.
Massachusetts Attorney General Andrea Joy Campbell called it a major victory for people seeking gender-affirming care, saying in an 18 August press release that the ruling blocks an attempt to make the treatment “more expensive and less accessible”.
Washington Attorney General Nick Brown similarly said the federal government had attempted to “illegally deny promised health coverage” relied upon by residents of his state in a 17 August press release.
The ruling comes as the Trump administration continues pursuing restrictions on gender-affirming healthcare at the federal level. Last Tuesday (11 August), the administration finalised another rule that would cut off federal Medicaid and CHIP funding for gender-affirming medical care provided to transgender young people.
This latest ruling doesn’t end the administration’s broader efforts to restrict access to gender-affirming care. However, it does prevent this particular Obamacare provision from taking effect, and for trans people who rely on ACA marketplace insurance, the distinction could be significant.
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