Texas and Montana have sued the U.S. Department of Health and Human Services (“HHS”), HHS Secretary Xavier Becerra, and other members of the Biden Administration for adopting a new rule that forces states to pay for “gender transition” procedures through their Medicaid programs and requires healthcare providers to perform these procedures even when doing so would violate state law. 

In May 2024, the Biden Administration promulgated a new rule under Section 1557 of the Affordable Care Act that would defund healthcare providers across the country who refuse to perform or pay for experimental, unproven, and potentially dangerous “gender transition” procedures. Under the new rule, any medical institution that refuses to perform the procedures can be stripped of all federal healthcare funds, including federal Medicaid and Medicare dollars. This rule further claims to preempt any state laws forbidding such procedures. 

The rule is a plainly unconstitutional attempt to override state law. The rule also relies on a misapplication of the Affordable Care Act which never authorized HHS or any government agency to compel institutions to perform or pay for these procedures. Attorney General Paxton has sued and has asked the court for injunctive relief to prevent the unlawful rule from being enforced. 

“This is yet another example of Joe Biden trying to sidestep the Constitution and use agency rulemaking to advance unpopular, unlawful, and destructive policies,” said Attorney General Paxton. “We are suing to stop the Biden Administration from withholding federal healthcare funds to force medical professionals to perform these experimental and dangerous procedures.”

To read the filing, click here.