The U.S. House of Representatives has passed a sweeping tax bill that includes provisions barring Medicaid and Affordable Care Act (ACA) marketplace plans from covering gender-affirming care for transgender individuals.
Initially aimed at minors, a late amendment expanded the restrictions to apply to all ages, removing references to age and minors. As passed, the bill prohibits Medicaid from covering gender transition-related procedures, including puberty blockers, hormone therapy, and surgeries. It also prevents ACA marketplace plans from including such care as an “essential health benefit.”
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This move could affect hundreds of thousands of transgender adults and an unknown number of minors. A recent report by the Williams Institute at UCLA found that around 180,000 trans adults rely on Medicaid, and a broader estimate suggests up to 312,000 may be impacted.
Critics, including LGBTQ advocates and major medical associations like the AMA and AAP, argue the bill undermines medically necessary care and spreads misinformation. Supporters, including President Donald Trump and many House Republicans, claim it protects minors from making irreversible medical decisions.
The bill reflects the Trump administration’s broader policy agenda, which includes multiple executive orders restricting transgender rights across healthcare, education, and military service.
It remains uncertain how the bill will fare in the Senate.
