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.
![Trump administration sets quota to arrest 3,000 people a day in anti-immigration agenda The target was delivered by Stephen Miller and Kristi Noem, and triples figures from earlier this year José Olivares in New York Thu 29 May 2025 23.14 BST Share The Trump administration has set aggressive new goals in its anti-immigration agenda, demanding that federal agents arrest 3,000 people a day – or more than a million in a year. The new target, tripling arrest figures from earlier this year, was delivered to Immigration and Customs Enforcement (Ice) leaders by Stephen Miller, the White House deputy chief of staff, and Kristi Noem, the Department of Homeland Security (DHS) secretary, in a strained meeting last week. The intense meeting, first reported by Axios and confirmed by the Guardian, involved Ice officials from enforcement and removal operations (ERO) and homeland security investigations (HSI) – both separate offices within DHS. ERO is in charge of immigration enforcement, including arrests, detention and deportation, while HSI typically focuses on investigating transnational crime, such as drug trafficking, human smuggling and the spread of online child abuse. The 21 May meeting in Washington DC is the latest example of the increasing pressure being placed on officials nationwide to increase the number of arrests of immigrants, as the administration doubles down on its anti-immigration agenda. The latest phase of the crackdown includes new tactics, such as mandating federal law enforcement agents outside Ice to assist in arrests and transports, more deputizing of compliant state and local law enforcement agencies, and arresting people at locations that were once protected, like courthouses. ice composite Trump officials increasingly recruit local police for immigration enforcement despite ‘red flags’ Read more “ This administration came into office with the illusion that they had been given a broad mandate to effectuate an aggressive immigration enforcement agenda, and they are doubling down now on that agenda,” said Nayna Gupta, the policy director for the American Immigration Council. “ Public polling is showing decreasing support for Trump’s immigration agenda, as Americans wake up to the reality that mass deportation means arrests of our neighbors and friends, masked agents in our communities and people afraid to go to work and show up to school, in ways that undermine our local economies.” Helter-skelter action has led to citizens caught up in the dragnet, Ice skirting due process – to the chagrin of the supreme court and lower courts – over-crowding in detention centers, arrests based on ideology and officials deporting people to third countries. “The sweeping Ice raids and arrests are hitting families, longtime residents, children and communities in a way never seen before,” said Jesse Franzblau, the associate director of policy for the National Immigrant Justice Center. As the number of people crossing the border into the US without authorization has plummeted even further than after the final Biden crackdown, operations in the US interior have increased. “Under Secretary Noem, we are delivering on President Trump’s and the American people’s mandate to arrest and deport criminal illegal aliens and make America safe,” Tricia McLaughlin, the homeland security assistant secretary, said in a statement. But even if the new target is fulfilled, it’s a far cry from Trump’s election campaign pledges to deport 15m to 20m people, which itself is more than the estimated 11m undocumented population. Agents with the FBI, HSI, Drug Enforcement Administration, Bureau of Alcohol, Tobacco, Firearms and Explosives and other federal law enforcement agencies have been co-opted from normal priorities to carry out immigration enforcement work. Current and former federal officials told the Guardian there is concern that important non-immigration-related investigations are falling by the wayside as a result. There has also been a huge escalation by local police and sheriff’s departments assisting, deputized by Ice to perform federal immigration arrests under a program called 287(g). Ice has also been targeting unusual places. On Tuesday, Ice and several other federal law enforcement agencies arrested roughly 40 people on the Massachusetts islands of Nantucket and Martha’s Vineyard. The US Coast Guard transported those apprehended, Ice said, angering some residents, local media reported. The agency has also been arresting people at courthouses throughout the country – a trend that has troubled advocates and policy analysts. “We’re seeing the Trump administration take the unprecedented step of arresting non-citizens who are following the government’s rules and procedures, and showing up for their court hearings,” said Gupta. “ They are desperate to reach a certain number of arrests per day. And the only way they can find non-citizens easily and quickly is to go to the courthouses, where they [immigrants] are doing exactly what they’re supposed to do.” On Wednesday, sources told the Guardian that officials had arrested people at two separate immigration courts in New York City. The outlet the City observed seven people arrested in a lower Manhattan court. Internal documents accessed by the Washington Post show Ice officers in more than 20 states have been instructed to arrest people at courthouses immediately after a judge orders them deported or after their criminal cases are dropped and they try to leave. The number of people held in detention by Ice reached 49,000 by 18 May, an increase of more than 10,000 since Trump took office, with the agency using local jails and federal prisons to hold immigrants, amid overcrowding. Austin Kocher, an assistant research professor at Syracuse University who closely tracks immigration detention data, said of the 3,000 daily arrest quota: “ The big question for me is: where are they going to put people?” Meanwhile, last month, the Trump administration ordered immigration judges to quickly dismiss cases by denying asylum seekers a hearing. The directive “has nothing to do with efficiency – it’s about slamming shut the courthouse door on people who have the right to seek asylum and a fair day in court”, Shayna Kessler, the director of the Advancing Universal Representation initiative at the Vera Institute of Justice, said. On Capitol Hill, the major spending bill passed by the House would balloon spending for immigration enforcement, at the US-Mexico border and in the interior, while cutting everyday services. Section of Trump's border wall Trump’s new border wall will threaten wildlife in an area where few people pass Read more “The administration is on a reckless spending spree, counting on Congress to bail them out for overspending hundreds of millions of dollars in private prison contracts with ties to top-level officials,” Franzblau said. He concluded: “It is beyond cruel to superfund Ice’s rampant violations of constitutional protections and expand the deadly immigration detention and enforcement apparatus.” Miller confirmed to Fox News on Wednesday that the White House was setting a goal for Ice to arrest at least 3,000 migrants per day, far above an earlier 1,000 per day arrest quota. Reuters reported later on Thursday that the Trump administration was removing two senior immigration enforcement officials amid demands to step up enforcement, three people familiar with the move said. Top Ice officials Kenneth Genalo and Robert Hammer will be pulled from their posts, the people told the news agency, requesting anonymity to discuss the shift. DHS denied that they were pushed out.](https://voicesrivercity.com/wp-content/uploads/2025/05/Screenshot-61-120x86.png)
