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Senate Weighs GOP Amendment Blocking Medicaid Gender-Affirming Care

Democrats plan to invoke the Byrd Rule to challenge the late-night provision after its narrow passage in the House

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pink pills on a yellow background
A screenshot of the revised section in H.R. 1, the One Big Beautiful Act of 2025, that reads: Sec. 44125. Prohibiting Federal Medicaid and CHIP Funding for Gender Transition Procedures. The photo is styled to have the trans flag colors, with the blue on top and pink on bottom. Two screenshots of a CTRL+F search on news stories show "transgender" and "gender-affirming" care as phrase not found.

Overview

  • A late-night amendment to the One Big Beautiful Bill Act bans Medicaid funding for gender-affirming procedures for minors and adults, passing the House 215-214 on May 22.
  • Approximately one in four transgender Americans relies on Medicaid for hormone therapies and surgical treatments, placing hundreds of thousands at risk if coverage is cut.
  • More than 27 states have restricted or banned gender-affirming care for minors, even as a Utah-commissioned study reported mental health and psychosocial improvements among treated trans youth.
  • Senate Democrats intend to invoke the Byrd Rule in budget reconciliation to remove the trans care ban, prompting a procedural fight on the chamber floor.
  • Major medical associations and Rep. Sarah McBride emphasize that gender-affirming care is medically necessary, pointing to HHS findings of no independent link between gender dysphoria and suicidality.