Trump cannot strip Obamacare protections from trans people’s healthcare, judge rules

A federal judge has struck down a Trump administration rule that would have prevented some gender-affirming care from being treated as an essential health benefit under the Affordable Care Act.Senior U.S. District Judge Nathaniel Gorton, who was appointed by Republican President George H.W. Bush, ruled Friday that the Department of Health and Human Services exceeded its authority when it barred insurers from treating certain forms of gender-affirming care as essential health benefits.A coalition of 20 states and Pennsylvania Gov. Josh Shapiro sued the Trump administration last year over several provisions of the rule. They argued that the changes were unlawful and would increase premiums and out-of-pocket expenses while causing people to lose health insurance. State officials cheered Gorton’s decision to grant them summary judgment on the gender-affirming care provision.Related: Trump DOJ backs private insurance company that court found discriminated against trans patients“The federal government tried to illegally deny promised health coverage that Washingtonians rely on,” said Washington state Attorney General Nick Brown. “As this administration tries to make health care more expensive and difficult to access, we will fight to keep it as affordable and accessible as possible in Washington.”The ruling focused on one provision of the sprawling 2025 Marketplace Integrity and Affordability Final Rule, which the administration promoted as an effort to curb improper enrollment and reduce federal spending. Beginning in 2026, the provision would have barred non-grandfathered individual and small-group insurance plans from treating certain gender-affirming procedures as essential health benefits.Insurers could still have voluntarily covered the care, and states could have required them to do so. But excluding it from essential health benefits would have stripped the care of important Affordable Care Act protections tied to federal subsidies and patients’ out-of-