Attorney General Kwame Raoul has led a coalition of 20 attorneys general in submitting comment letters opposing two proposed rules from the United States Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS). The coalition argues that these rules would prevent hospitals and medical providers from offering, and youth from receiving, transgender healthcare by threatening to withhold funds through 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.”
The CMS proposals, announced in December 2025, would bar hospitals from providing medically necessary transgender healthcare to youth by withholding Medicaid and Medicare funds from hospitals that offer such care. They would also prohibit state Medicaid and Children’s Health Insurance Program (CHIP) plans from using federal funding for transgender youth healthcare.
According to Raoul, these measures would remove states’ roles as administrators of Medicaid, which is a responsibility granted by Congress. The hospital conditions rule could result in both public and private hospitals in Illinois losing all Medicare and Medicaid funding if they provide transgender youth healthcare. The coalition contends that CMS lacks authority to take away states’ ability to regulate medical practice or ensure access to necessary care for residents.
In their letters, Raoul and other attorneys general argue that these proposed rules infringe on state rights over medicine regulation, violate constitutional provisions such as the Spending Clause and Equal Protection Clause, and contradict statutes like the Social Security Act, Affordable Care Act, Administrative Procedure Act, as well as nondiscrimination laws. They claim HHS is discriminating against transgender youth despite existing medical evidence.
The coalition also points out that CMS relies on an HHS report criticized for methodological flaws; it was published anonymously without peer review at presidential direction. Additionally, they note that HHS did not consider costs imposed on affected families or providers.
Attorneys general joining Raoul include those representing 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.
The Illinois Attorney General’s office regularly advocates for vulnerable groups such as workers and immigrants while handling thousands of consumer complaints each year. It also aims to protect consumers’ interests and promote safer communities, extending its advocacy efforts statewide through partnerships with law enforcement agencies and offering services related to civil rights. As Illinois’ primary legal officer the office supports residents with resources covering identity theft prevention among other issues.