Sponsors (7)
The bill reduces federal Medicaid financial support for most gender-affirming care for minors—saving federal funds and clarifying billing rules for providers—while substantially restricting access to those services for low-income transgender youth and creating possible legal complications for non-binary/intersex patients.
State governments, Medicaid programs, and healthcare providers will get clearer federal legal definitions of 'sex' and 'specified gender transition procedures,' reducing ambiguity in Medicaid billing and compliance.
U.S. taxpayers and the federal budget will see reduced federal Medicaid matching payments for gender-affirming surgeries and hormones for minors, lowering federal spending on those services.
Children with established medical indications (e.g., precocious puberty, certain differences of sex development, life‑threatening conditions) will continue to have clarified federal Medicaid support through explicitly preserved exceptions.
Low-income transgender minors on Medicaid will lose federal coverage for puberty blockers, cross-sex hormones, and many gender-affirming surgeries, likely increasing out-of-pocket costs or blocking access to care.
Medicaid enrollees who are transgender minors may face further reductions in available services because states can restrict or remove coverage to avoid paying without a federal match.
Intersex patients and people whose development does not fit binary definitions may encounter legal and administrative conflicts from statutory biological definitions of 'male' and 'female,' complicating care.
Based on analysis of 2 sections of legislative text.
Prohibits Federal Medicaid matching funds for specified gender‑transition surgeries, implants, puberty blockers, and supraphysiologic hormones when provided to individuals under 18, with narrow medical exceptions.
Prohibits Federal Medicaid matching funds for a defined set of “gender transition” procedures and related drugs when those services are provided to individuals under 18 enrolled in State Medicaid plans or waivers. The text lists specific surgeries, implants, use of puberty blockers and supraphysiologic sex hormones for minors, and provides narrow exceptions for treatment of precocious puberty, certain genetic sex‑development conditions, emergencies, injuries/disease from prior covered procedures, and reconstructive procedures — generally requiring parental or guardian consent for exceptions.
Introduced January 16, 2025 by Daniel Crenshaw · Last progress December 18, 2025