Dive Brief:
- The CMS on Tuesday moved to end federal Medicaid funding for youth gender-affirming care, the latest in a string of actions by the Trump administration to restrict access.
- States will be barred from using federal Medicaid funds for gender-affirming care for individuals under the age of 18 starting mid-October, according to the new CMS rule. The Children’s Health Insurance Program will also be barred from providing the care, which includes puberty blockers and surgical operations, to people under the age of 19.
- The CMS estimates the policy will reduce federal Medicaid spending by about $175 million over the next decade. In 2023, Medicaid and CHIP spending for gender-affirming care for minors totaled $31 million, a fraction of the $923.7 billion in total Medicaid and CHIP spending that fiscal year.
Dive Insight:
Medicaid and CHIP funding will remain available for up to six months after Oct. 13 for children on hormone therapy, the CMS said. Additionally, the federal programs will continue to fund mental health services for transgender youths.
The CMS says its decision follows a literature review by the Trump administration last year, which encouraged providers to rely on behavioral therapy for treating gender dysphoria in those under 19 and broadly disavowed hormone therapies, puberty blockers and surgery for gender-affirming care.
“Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits,” CMS Administrator Dr. Mehmet Oz said in a statement.
It’s the latest action by the Trump administration to bar gender-affirming care for adolescents, a priority for President Donald Trump. In his first days in office, Trump issued an executive order that prevented providers from offering gender-affirming services to patients under 19. The executive order was met with broad opposition from provider groups, most of which endorse gender-affirming care for minors, and its major provisions were blocked by federal judges.
Since then, the Trump administration has tasked the Department of Justice with investigating providers and drug manufacturers that provide gender-affirming care for minors, and pressured hospitals to stop providing the care.
Several major hospitals, including Kaiser Permanente and the University of Pittsburgh Medical Center, paused gender-affirming surgeries for minors as a result.
Without federal Medicaid and CHIP funding, states will be left to make their own coverage determinations. Some states, like California, have said they will fund investments to support gender-affirming care.
“Families, doctors, and communities will now be forced into unimaginable choices both in where they can get their care, and how to pay for it,” Amanda McAllister-Wallner, executive director of Health Access California, a consumer advocacy group, said in a statement.
