The U.S. Department of Health and Human Services (HHS) has moved a proposal that would restrict Medicaid and Medicare funding for hospitals providing gender-affirming care to minors to its "Long-Term Actions" list. According to an entry in the administration’s unified agenda, the final action date for the rule is now set for December 2028.
The proposed rule, introduced in December 2025, received more than 30,000 public comments. Proponents of the measure, including HHS spokesperson Emily Hilliard, stated the administration intends to reject "ideologically driven surgical interventions." Legal experts, including University of Michigan law professor Sam Bagenstos, have questioned the rule's legality, suggesting it may violate the Medicare Act by attempting to control medical practices typically regulated by states.
While the shift to long-term status indicates the rule is not currently in the final stages of review, the administration maintained that the policy has not been abandoned. In a statement on social media, HHS indicated it is continuing to review public comments and plans to eventually issue a final rule. Currently, the proposal has not been sent to the Office of Management and Budget for final clearance.