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HHS Moves to Bar Medicare and Medicaid From Hospitals Offering Gender-Affirming Procedures to Minors

The proposal wields federal program eligibility to pressure providers, tapping programs that account for roughly 45% of hospital spending.

Overview

  • At an HHS press conference, CMS Administrator Dr. Mehmet Oz backed the move and described gender-affirming care for minors as a pathology while accusing clinicians of profiteering.
  • Dr. Oz cited 2022 JAMA figures estimating $60,000 for vaginoplasty and $150,000 for phalloplasty, while other reporting highlighted lower price ranges and studies showing such surgeries for minors are rare.
  • Coverage described two proposed rules: blocking Medicaid reimbursement for gender-affirming care for those under 18 and cutting Medicare and Medicaid funding to any hospital that provides pediatric gender-affirming care.
  • The action follows a January executive order by President Trump targeting gender-affirming care for minors and comes after a Supreme Court decision last month allowing a related passport policy to proceed.
  • HHS announced the policy through rulemaking, signaling pending implementation with major financial implications for hospitals given Medicare and Medicaid’s large share of revenue.