The ruling from U.S. District Judge Peter Welte, the chief federal judge in North Dakota, bars the U.S. Department of Health and Human Services from enforcing a health care rule it imposed in 2024 under Democratic President Joe Biden. The rule said that existing policies against sex discrimination covered discrimination based on gender identity, so that health care providers risked losing federal funds if they refused to provide gender-affirming care.

Welte also barred the U.S. Equal Employment Opportunity Commission from telling employers that a failure to have health plans cover gender-affirming care for their workers would represent discrimination based on sex that could lead to a lawsuit against them and penalties.