Press Release: 8/19/2026

AG Campbell Secures Major Court Victory Protecting Coverage Of Gender-Affirming Care Under The Affordable Care Act

 

FOR IMMEDIATE RELEASE:

8/18/2026

 

BOSTON — Massachusetts Attorney General Andrea Joy Campbell and a coalition of 20 other states 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.

“This victory blocks the Trump Administration’s attempt to make gender-affirming care more expensive and less accessible,” said AG Campbell. “Gender-affirming care is critical to the emotional and physical wellbeing of transgender individuals, and the Trump Administration does not have the authority to unlawfully make this care less accessible and more expensive for patients and families. I will continue to fight for the rights of all our residents to have affordable access to essential healthcare.”

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.

On August 14, the U.S. District Court for the District of Massachusetts ruled that the Trump Administration unlawfully modified the ACA’s essential health benefit categories without following the procedures required by federal law. The court’s decision vacates the provision that would have excluded certain types of gender-affirming care from the essential health benefits covered under ACA plans.

In July 2025, AG Campbell co-led a coalition of 20 other states in filing 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. The essential health benefits provision had not previously been vacated and was not challenged in the Maryland litigation. 

###