California Attorney General Rob Bonta has joined a group of 21 attorneys general in submitting two comment letters to the U.S. Department of Health and Human Services (HHS), opposing proposed rules that would restrict federal funding for providers of gender-affirming care. The first letter challenges HHS’s proposal to prohibit federal reimbursement for gender-affirming care for minors under Medicaid and the Children’s Health Insurance Program (CHIP). The second letter opposes a rule that would bar healthcare facilities providing such care to adolescents from participating in Medicaid and Medicare.
Attorney General Bonta stated, “The Trump Administration is trying to advance cruel and unlawful new rules that seek to deny transgender Americans access to crucial care. The Trump Administration continues to overstep its authority in pursuit of a hateful agenda against transgender individuals’ rights. If HHS attempts to finalize rules that are similar to these proposals, we stand ready to use every tool in our toolbox to prevent them from ever going into effect. We are committed to defending California and other states’ rights to administer their healthcare programs. We will continue to fight to safeguard patients and their trusted healthcare providers from Trump’s baseless attacks.”
On December 18, 2025, HHS issued Notices of Proposed Rulemaking for two rules: one would stop Medicaid and CHIP from paying for medically necessary gender-affirming healthcare for anyone under age 18 (Medicaid) or 19 (CHIP); the other would prevent healthcare facilities providing such care from participating in Medicaid and Medicare. The public comment period on these proposed rules ended yesterday. HHS may issue final rules after reviewing comments, with the possibility they could take effect 60 days later unless blocked by a court.
In their comment letters, Bonta and the coalition argue that these proposals infringe on states’ rights by interfering with state regulation of medicine and administration of Medicaid plans. They contend there is no legal basis for changing conditions of participation in federal health programs as proposed by HHS, which seeks to exclude providers based on specific medical services offered.
California law prohibits discrimination based on sexual orientation or gender identity through statutes such as the Unruh Civil Rights Act and Government Code section 11135. Denying services due to gender identity or diagnosis amounts to discrimination, according to state law protections covering both patients seeking gender-affirming care and the professionals providing it. Medi-Cal, California’s Medicaid program, includes coverage for gender-affirming care for minors.
Attorney General Bonta has previously opposed similar actions at the federal level aimed at restricting access or targeting records related to gender-affirming care, joining coalitions challenging subpoenas for patient records from telemedicine platforms and hospitals, as well as contesting executive orders threatening providers with prosecution.
Bonta signed these recent letters alongside attorneys general from New York, Connecticut, Illinois, Massachusetts, New Mexico, Washington, Arizona, Colorado, the District of Columbia, Delaware, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, Oregon, Rhode Island, Vermont and Wisconsin.
Rob Bonta leads the California Attorney General’s office according to its official website. The office serves as California’s chief law enforcement authority and is part of the state’s executive branch, focusing on enforcing state laws while protecting public rights across areas including civil rights and consumer protection throughout California.
