The U.S. Department of Health and Human Services on Tuesday finalized a rule barring Medicaid and the Children's Health Insurance Program from funding gender-affirming care, with the policy scheduled to take effect on October 13 unless blocked by legal challenges.
HHS finalizes rule ending Medicaid and CHIP coverage for gender-affirming care
The U.S. Department of Health and Human Services on Tuesday finalized a rule barring Medicaid and the Children's Health Insurance Program from funding gender-affirming care, with the policy scheduled to take effect on October 13 unless blocked by legal challenges.
The rule was first proposed in December and drew nearly 35,000 public comments, approximately 90% of them opposing the change, according to Ma'ayan Anafi, senior counsel for health equity and justice at the National Women's Law Center.
HHS cited international reviews of medical evidence in support of the rule, including the Cass Review conducted in the United Kingdom. The department did not reference a more recent report from the Netherlands, which, according to the source, found that gender-affirming care is safe and effective and should be widely supported. The Cass Review has itself been widely criticized for skewing the evidence, according to the source.
In December, HHS also proposed a separate rule that would bar any health systems receiving Medicaid and Medicare payments — described in the source as the vast majority of U.S. health systems — from providing gender-affirming care. No further announcements on that proposal have been made.
Separately, HHS used a little-known statute to refer health systems to prosecutors for offering gender-affirming care, leading to abrupt terminations of care at dozens of major providers. A federal judge blocked that prosecution effort in an April ruling that described HHS Secretary Robert F. Kennedy Jr. as showing 'wanton disregard' for the law and deemed his actions 'unsafe.'
On August 3, federal employees and their families filed a class-action lawsuit against the Trump administration over the ending of insurance coverage for gender-affirming care.
If the Medicaid and CHIP rule does take effect, children enrolled in those programs would be given up to six months to taper off medications. States could separately choose to use their own portion of Medicaid funds, not reimbursed by the federal government, to continue covering such care. Gender-affirming care can include puberty blockers, hormones such as estrogen and testosterone, medical monitoring including bloodwork, family support, and, less commonly among children, surgery.
- The source does not state the estimated number of children enrolled in Medicaid or CHIP who are currently receiving gender-affirming care and would be affected by the rule.
- The source does not state the total federal expenditure on gender-affirming care through Medicaid and CHIP.
- The source does not identify which specific courts or cases Anafi references when stating that courts have recognized these actions as prejudice-based.
- The source does not state what findings the Netherlands report cited is based on, including its sample size or methodology.
- The source does not state whether any legal challenge to the new rule had been filed as of the date of publication.
- The source does not state what specific evidence HHS reviewed beyond the Cass Review in formulating the final rule.
Read the original at The Guardian US