Overview
- U.S. District Judge Mustafa Kasubhai, who issued a 49-page opinion Saturday, vacated HHS Secretary Robert F. Kennedy Jr.’s December declaration and permanently blocked HHS from enforcing it or any materially similar policy against providers in 21 states and Washington, D.C.
- The December 18 declaration labeled youth gender-affirming treatments as failing professional standards and threatened to cut hospitals off from Medicare and Medicaid, and HHS then referred children’s hospitals to its inspector general as roughly 40 systems paused care.
- The court found HHS exceeded its legal authority, skipped required notice-and-comment procedures, and could not override state standards of care, while rejecting the government’s claim the declaration was merely Kennedy’s personal opinion as a “bald-faced lie.”
- The order lifts a major federal risk for hospitals in the covered states and has prompted moves to resume services, yet it does not extend to the rest of the country and separate CMS proposals to end federal payments for youth gender care remain pending.
- HHS said it will continue to fight the case, and state officials such as California’s attorney general told providers that gender-affirming care remains legal under state law, a stance that could spur more enforcement of state nondiscrimination rules.