The Trump administration announced that Medicaid and the state Children's Health Insurance Program (CHIP) will stop paying for gender-affirming surgeries and hormone treatments for minors. Under the new policy, Medicaid will no longer cover these treatments for transgender individuals under age 18, and CHIP will end coverage for those under 19. The policy is scheduled to take effect on Oct. 13.
This decision follows a series of executive actions regarding transgender individuals that began when President Trump returned to office last year. The administration previously announced plans to cut off Medicaid and Medicare funding for hospitals that provide gender-affirming care to minors. Other recent policies include barring transgender athletes from female sports competitions and removing the "X" sex designation option on U.S. passports.
The new rule specifies that Medicaid and CHIP will continue to fund mental health treatment for transgender youth. However, coverage for hormone treatments—which include puberty blockers and cross-sex hormones—will be phased out. For minors already receiving these treatments, coverage is set to end by April 2027. The Centers for Medicare and Medicaid Services (CMS), the agency overseeing these programs, did not respond to questions regarding the policy on Tuesday.
President Trump stated in a social media post that he directed CMS Administrator Dr. Mehmet Oz to implement the change, characterizing the procedures as "barbaric" and citing concerns about "irreversible harm." Conversely, Josh Rovenger of GLBTQ Legal Advocates and Defenders stated the rule creates barriers for parents making medical decisions and will face legal challenges. Human Rights Campaign President Kelley Robinson said the administration is "terrorizing trans youth and their families" and noted that her organization is already suing over related federal benefit changes.
The scale of the fiscal impact is not yet fully known, as CMS has not reported how much taxpayer funding currently goes toward these treatments. While the source notes that surgeries for minors are rare, puberty blockers and hormone treatments are more common. The policy creates a federal precedent for restricting specific medical treatments based on age and diagnosis within public insurance programs. This follows a report released by the administration last year that urged therapy-only approaches for transgender youth rather than medical interventions.
Knock-on effects are expected to center on the legal system and hospital operations. Major medical organizations, including the American Medical Association, support access to this care, though the American Society of Plastic Surgeons has cited "insufficient evidence" regarding the benefits of certain surgeries for minors. The policy is expected to face immediate litigation from advocacy groups like GLBTQ Legal Advocates and Defenders. Previous administration actions on this topic have seen mixed results in court; the Supreme Court allowed sports bans and passport changes to stand, while a lower court ruled against an administration declaration regarding the safety of these treatments. The policy is officially set to begin on Oct. 13.