Sponsors (7)
The bill narrows federal Medicaid coverage for gender-affirming care for minors—reducing federal spending and clarifying reimbursement rules—but at the cost of significantly reduced access for low-income minors, fewer willing providers, and potential rights and administrative consequences.
State Medicaid programs and providers get clearer federal rules distinguishing covered versus excluded services, reducing ambiguity about reimbursement and simplifying billing decisions for states and hospitals.
Children with precocious puberty and patients with certain disorders of sex development (DSD) will retain Medicaid-covered access to puberty blockers or related care when medically indicated.
Taxpayers face reduced federal Medicaid spending because federal funds will not be used for gender transition procedures for minors.
Medicaid-enrolled minors who seek gender-affirming care will lose federal Medicaid coverage for those treatments, increasing out-of-pocket costs or preventing access.
States may remove or restrict gender-affirming services from their Medicaid programs rather than cover them with state funds, disproportionately reducing access for low-income and rural communities.
Clinicians and pharmacies that prescribe or provide excluded hormones or procedures for gender transition for minors may lose Medicaid reimbursement, discouraging providers from offering such care and shrinking provider networks.
Based on analysis of 2 sections of legislative text.
Prohibits federal Medicaid matching payments for a wide range of gender transition procedures and certain hormone treatments when provided to people under 18. It amends the Social Security Act to define "specified gender transition procedures," conditions federal matching funds on states excluding those services for minors, and lists narrow medical exceptions (e.g., treatment for precocious puberty, certain disorders of sex development, life‑threatening conditions, complications, or restorative surgery after a prior procedure). The change affects State Medicaid programs, providers who deliver the listed services, Medicaid enrollees under 18 and their families, and the federal agency that administers Medicaid by adjusting which state expenditures are eligible for federal matching funds. The bill does not appropriate new funds or authorize new spending.
Introduced January 16, 2025 by Daniel Crenshaw · Last progress December 18, 2025