Tong says federal court struck down ACA rule limiting gender-affirming care coverage
Connecticut's attorney general said a multistate coalition won a ruling in U.S. District Court in Massachusetts voiding part of a federal rule that would have removed certain gender-affirming care from the Affordable Care Act's essential health benefits.
A federal judge in Massachusetts has struck down a provision of a Trump administration rule that would have excluded certain types of gender-affirming care from the list of essential health benefits under the Affordable Care Act, Connecticut Attorney General William Tong announced Aug. 18.
According to the Office of the Attorney General in Hartford, the U.S. District Court for the District of Massachusetts ruled that the administration unlawfully modified the categories of essential health benefits without following the procedures the ACA requires. Benefits in those categories are subject to the law's financial protections, including limits on out-of-pocket costs, the office said.
The rule at issue, described by the office as the "Marketplace Integrity and Affordability" rule, was proposed in March 2025 and was intended to curb alleged enrollment fraud and reduce federal spending on subsidies that help consumers afford ACA coverage, according to the release. Among other changes, the office said, it would have removed certain gender-affirming care from the ACA's 10 essential health benefit categories.
Tong and a multistate coalition sued in July 2025, challenging nine provisions of the rule on grounds that they would make coverage harder to obtain, increase costs for states and weaken ACA protections, the office said. Seven of those provisions were vacated in separate litigation, City of Columbus et al. v. Kennedy et al., in the U.S. District Court for the District of Maryland, according to the release.
"We sued, and we stopped them, and we're going to keep fighting to protect access to affordable healthcare free from partisan interference," Tong said in the release.
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