Attorney General Tong Secures Major Court Victory Protecting Gender Affirming Care Under the Affordable Care Act

08/18/2026

(Hartford, CT) — As part of a multistate coalition, Attorney General William Tong on Friday secured a major victory after the U.S. District Court for the District of Massachusetts struck down a key provision of a Trump Administration final rule that would have excluded coverage of certain types of gender-affirming care as essential health benefits under the Affordable Care Act (ACA). Essential health benefits are subject to the ACA’s financial protections, including limits on out-of-pocket costs.

“Last year, the Trump Administration rolled out mountains of new red tape to charge Americans more money for worse coverage, including politically motivated exclusions on gender-affirming care. We sued, and we stopped them, and we’re going to keep fighting to protect access to affordable healthcare free from partisan interference,” said Attorney General Tong.

The final rule at issue — the “Marketplace Integrity and Affordability” rule — was proposed by the Trump Administration in March 2025 to curb alleged ACA enrollment fraud and reduce federal spending on subsidies that help consumers afford ACA coverage. Among other changes, the rule would have removed certain types of gender-affirming care from the ACA’s 10 essential health benefit categories.

In July 2025, Attorney General Tong and the coalition filed a lawsuit challenging nine separate provisions of the final rule, arguing that they would make it harder for consumers to get coverage through the ACA, increase costs for states, and weaken key ACA protections. Seven were later vacated in separate litigation, City of Columbus et al. v. Kennedy et al., in the U.S. District Court for the District of Maryland. On Friday, the U.S. District Court for the District of Massachusetts ruled that the Trump Administration unlawfully modified the categories of essential health benefits without following the proper procedures the ACA requires.

Twitter: @AGWilliamTong

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Media Contact:

Elizabeth Benton
elizabeth.benton@ct.gov

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