Families Sue Over Federal Medicaid Rule on Youth Care
Four New Hampshire families asked a federal judge to block a Medicaid rule restricting gender-affirming care for transgender youth.
Updated on Nov. 3, 2026 in LGBTQ+
Four New Hampshire families sued the Trump administration over a federal rule barring Medicaid and CHIP from paying for gender dysphoria treatment for some transgender youth. A hearing on their request for a preliminary injunction was held before U.S. District Judge Steven J. McAuliffe, and no decision timeline has been set.
Why it matters
The plaintiffs argue ending Medicaid coverage would be devastating for families who cannot afford to pay privately. The federal government contends the Centers for Medicare & Medicaid Services has authority over which care it covers and says the procedures have irreversible consequences.
Four New Hampshire families are plaintiffs in the case, and the federal rule took effect October 13. The 2025 New Hampshire ban on new gender-affirming care patients under 18 is separate from the federal rule, and the ruling in the case will not affect that state ban.
The players
Steven J. McAuliffe
A U.S. District Judge who presided over the hearing on the preliminary injunction request in New Hampshire.
GLAD Law
A legal organization focused on LGBTQ+ civil rights litigation that co-filed the lawsuit on behalf of the families.
ACLU of New Hampshire
The state affiliate of the American Civil Liberties Union, which co-filed the lawsuit challenging the federal rule.
The details
The federal rule bars Medicaid and CHIP benefits from paying for gender dysphoria treatment and medication for transgender youth. One plaintiff, a teenager in Hillsborough County, is unable to receive puberty blockers under the rule, and the plaintiffs are covered under the continuing care clause of New Hampshire's ban. The lawsuit was filed by GLAD Law, the National Center for LGBTQ Rights, the ACLU of New Hampshire, and Robinson + Cole.
Timeline
October 13, 2025: The federal Medicaid and CHIP rule took effect.
2025: New Hampshire banned gender-affirming care for new patients under 18.
Friday before publication: A hearing was held on the preliminary injunction request.
Legal Context
The federal government cites Armstrong v. Exceptional Child Center to argue the Centers for Medicare & Medicaid Services controls which care Medicaid covers. The families' challenge tests how far that authority reaches when it affects transgender youth seeking established medical treatment.
Transgender youth in New Hampshire whose families rely on Medicaid or CHIP may lose coverage for gender dysphoria treatment and puberty blockers if the federal rule stands. Families in the state who cannot afford to pay privately face the most direct financial exposure from the outcome.
The takeaway
The outcome of this case will determine whether federal Medicaid and CHIP coverage remains available to some transgender youth in New Hampshire while the litigation proceeds. Families watching the case should track court filings and their own coverage status.
Further reading
For more on how these policy fights affect families, see the LGBTQ+ section.
Source note: This article includes information reported by Monadnock Ledger-Transcript.
