WEEKLY UPDATE: 02/19/26
In a comment letter submitted to the U.S. Department of Health and Human Services (HHS), the Connecticut Hospital Association (CHA) urged the department to withdraw the proposed rule, “Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children,” arguing it unfairly and illegally interferes with patient rights, institutional provider rights, practitioner rights, and state law determinations regarding healthcare and the practice of medicine.
Published in the Federal Register (File Code CMS-3481-P) on December 19, 2025, the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoP) proposed rule seeks to bar hospitals from performing pharmaceutical or surgical interventions, described by HHS as “sex-rejecting procedures” (SRPs). CHA argues that, fundamentally, the proposed rule is unenforceable and void because it violates the Social Security Act, and Connecticut law protects the right to access this type of care.
The CHA comment letter reads in part:
The decisions about this type of care, often heart-wrenching decisions, require significant medical assessment, access to sophisticated facilities and care teams, and will benefit from ongoing research and advancements in treatment. These types of care are inextricably in the realm of the practice of medicine, outside the purview of HHS. In states that allow these types of care, decisions should be left to patients and their families in consultation with their medical providers without interference from the federal government.
Click here to read the full letter.
Click here to read the American Hospital Association’s (AHA) comment letter to CMS on the proposed rule.
Connecticut Attorney General Leads Coalition Opposing Proposed Rules Preventing Access to Gender-Affirming Care for Youth
This week, a coalition of 20 attorneys general, co-led by Connecticut Attorney General William Tong, submitted comment letters opposing the “Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children” proposed rule (File Code CMS-3481-P), as well as the related “Medicaid Program; Prohibition on Federal Medicaid and Children’s Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children” proposed rule (File Code CMS-2451-P).
The attorneys general’s letter on File Code CMS-3481-P, which would prohibit hospitals from providing certain forms of healthcare for transgender youth as a condition of participation in the Medicare and Medicaid programs, asserts the change is “an unlawful overreach.” The coalition’s letter reads in part:
The Undersigned States strongly oppose the Proposed Rule and urge HHS to continue to permit Medicaid and Medicare participating hospitals to provide medically necessary healthcare to transgender youth. As Attorneys General, we are deeply concerned that the Proposed Rule is merely a pretextual attempt to further this Administration’s ongoing efforts to undermine the essential rights of youth living with gender dysphoria nationwide, including in states with laws that protect their right to receive medically necessary healthcare. With no regard for states’ historic role and interests, the Proposed Rule would cast aside the established federal-state partnership over administration of the Medicaid and Medicare Programs that rely on “state lawmakers, not the federal government,” as “the primary regulators of professional [medical] conduct.”
The coalition includes attorneys general of Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont, Washington, and Wisconsin.
Related News:
HHS Announces Proposed Rules Prohibiting Hospitals From Providing Gender-Affirming Care for Children
