Key facts
- Medicaid and CHIP will cease funding gender-affirming care for transgender minors.
- The rule is effective in October and impacts children under 18 (Medicaid) and 19 (CHIP).
- The administration cited weak evidence and risks of irreversible harm as reasons for the decision.
- Major medical organizations support gender-affirming care for minors.
- Existing hormone therapy patients will receive a six-month taper-off period for hormones only.
The Trump administration has finalized a rule that will prevent two major federal health programs, Medicaid and the Children's Health Insurance Program (CHIP), from funding gender-affirming care for minors. This policy change, effective in October, will halt coverage for puberty blockers, hormone therapy, and surgeries for transgender individuals under 18 in Medicaid and under 19 in CHIP. The administration cited a lack of strong evidence supporting the benefits of these treatments and concerns about irreversible harm to children.
Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz stated that the decision aligns with scientific understanding, saves taxpayer money, and protects children. However, this move contradicts the stance of major medical organizations like the American Academy of Pediatrics and the American Medical Association, which support gender-affirming care and believe such decisions should be made by healthcare professionals, parents, and children.
The administration asserts its authority to cut funding based on the Medicaid statute's requirement that care serve beneficiaries' best interests, a novel interpretation that opponents argue exceeds its power. Despite widespread public opposition to the proposed cuts, the government proceeded with finalizing the rule. This decision is expected to create conflict with states that have enacted 'shield laws' to protect gender-related care, potentially requiring them to cover the costs themselves.
President Donald Trump took credit for the policy, directing Dr. Oz to end funding for what he described as 'barbaric surgeries and practices' on minors. While savings were touted, the projected federal savings of $138 million over a decade represent a small fraction of overall program spending. The rule includes a six-month grace period for children already receiving hormone therapy to taper off, though this does not apply to surgeries or puberty blockers and only benefits those already in treatment.