In a move that could effectively halt gender-affirming treatments for children, the U.S. Department of Health and Human Services announced a series of regulatory actions on Thursday. The proposals aim to cut federal Medicaid and Medicare funding for hospitals that provide puberty blockers, hormone therapy, or surgical interventions to minors.
The Scope of the Proposed Rules
The Department’s notice, posted on Thursday morning, outlines three core restrictions:
- Federal Medicaid and Medicare payments will be barred for any hospital that offers gender-affirming care to children.
- The same funding limits will apply to the State Children’s Health Insurance Program (CHIP), a federal program that supports low-income families.
- Hospitals that continue to provide such care would face a loss of all federal reimbursements for those services.
These actions build on earlier Trump-era limits on transgender rights and represent the most significant federal effort to restrict gender-affirming care for minors to date.
How the Funding Cuts Work
Under current federal law, Medicaid and Medicare reimburse hospitals for a wide range of medical services. The new rules would add gender-affirming procedures to the list of services that cannot be reimbursed. Hospitals would have to self-fund any care they provide to minors, or seek alternative payment sources.
The notice does not yet contain final language. HHS will issue a final rule after a public comment period, during which the public can submit opinions on the proposed restrictions.
Potential Impact on Children and Families
Health care providers warn that the funding cuts could leave many transgender youth without access to life-saving treatments. Puberty blockers, for example, are considered standard care for adolescents experiencing gender dysphoria. Without federal reimbursement, hospitals may be forced to discontinue these services.
The restrictions also threaten to widen existing disparities. Minority and low-income families already face challenges accessing gender-affirming care. The loss of federal funding could push more providers to stop offering these services altogether.
Legal and Policy Context
The proposed rules follow a broader pattern of Trump-era policies aimed at limiting transgender rights. Earlier actions included restrictions on the use of public facilities and the expansion of anti-transgender employment protections. The new HHS regulations would be the first major federal measure targeting medical care for transgender youth.
The Department’s notice cites the Affordable Care Act’s requirement that Medicaid and Medicare reimburse all medically necessary services. The proposed exclusions would carve out gender-affirming care as a non-necessary service, a position that is likely to face legal challenges.
Stakeholder Reactions
Transgender advocacy groups have condemned the proposals. They argue that the rules could endanger the lives of LGBTQ+ youth by forcing hospitals to choose between federal funding and providing care. The American Medical Association and other professional societies have also expressed concerns about the potential health risks.
Supporters of the restrictions, including some Republican lawmakers, say the rules protect children from what they describe as “unnecessary” medical interventions. They argue that parents should have a say in medical decisions for minors.
Next Steps
The Department of Health and Human Services will open a public comment period, allowing stakeholders to submit feedback on the proposed rules. After reviewing comments, HHS will publish a final rule that will take effect at a later date.
The timing of the announcement is significant. It comes as other Trump-era policies, such as the reclassification of marijuana and the renaming of the Kennedy Center, have drawn public attention. The HHS move adds another high-profile policy shift to the administration’s agenda.
Key Takeaways
- HHS proposes to cut Medicaid and Medicare funding for hospitals that provide gender-affirming care to minors.
- The same funding restrictions will apply to the State Children’s Health Insurance Program (CHIP).
- The rules are the most substantial federal action against transgender care for children in the Trump administration.
The proposed regulations could reshape the landscape of gender-affirming care for transgender youth across the country. Stakeholders will closely monitor the public comment period and the eventual final rule.
Closing
The HHS announcement marks a decisive step in the administration’s broader strategy to limit transgender rights. Whether the proposed funding cuts will be implemented or overturned remains to be seen, but the announcement has already sparked intense debate among health professionals, advocacy groups, and lawmakers.
