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The Trump administration has drafted proposals for two new rules that would prohibit Medicaid and Medicare programs from funding gender-affirming health care services for people under 19.
Although the proposal has not yet been made public, NPR The public broadcasting network obtained draft text of both rules from an anonymous employee of the Centers for Medicare and Medicaid Services (CMS), which first reported on Thursday. one rule It reportedly would ban Medicaid reimbursement for gender-affirming care provided to trans youth under 18 and reimbursement under the Children’s Health Insurance Program (CHIP) for trans patients under 19. different Withhold all federal Medicare and Medicaid funding for hospitals providing “pediatric gender reassignment care.”
The full text of both rules is expected to be submitted in November, and will go through a public comment period, an anonymous CMS official told NPR. Both rules reportedly do not mention a report commissioned by Utah Republicans released last May that concluded that treatments such as hormone therapy and gender reassignment surgery are “effective” and “safe” and that bans on such treatments “cannot be justified.”
If this rule is adopted and survives a challenge in the court system, it could effectively block hospitals across the United States from providing gender-affirming care to transgender youth and 18-year-olds. (There are currently about 724,000 trans youth ages 13 to 17 living in the United States, making up about a quarter of the total U.S. trans population, according to an August Williams Institute estimate.)
“Medicare accounts for a significant portion of many hospitals’ revenue, so hospitals will have no choice but to deny that care even to patients with private insurance,” Katie Keith, a health policy expert at Georgetown University, told NPR.
CMS is currently a department of the Department of Health and Human Services (HHS) headed by Robert F. Kennedy Jr. While CMS has championed conversion therapy, it has rejected the concept of trans identity wholesale, ended 988 LGBTQ+ youth specialty services programs, and sought to eliminate hundreds of funding streams for HIV/AIDS research. HHS reportedly did not respond to NPR’s request for comment on the proposed rule this week.
