Trump Cuts Medicaid Funding for Youth Gender-Affirming Care

The finalized rule, published by the Centers for Medicare & Medicaid Services, will bar Medicaid from covering gender-affirming surgeries and hormone treatments for minors, while the Children’s Health Insurance Program will stop covering such treatments for individuals under 19. Puberty blockers, hormone therapy, and surgeries are among the affected services, though mental health care for transgender youth remains covered.

The policy takes effect on October 13, 2026, and includes a six-month transition period for minors already receiving hormone therapy. The administration projects the change will reduce federal spending by $138 million over the next decade, a figure that differs from an earlier estimate of $235 million in savings.

Administration officials, including Centers for Medicare & Medicaid Services Administrator Mehmet Oz and Health and Human Services Secretary Robert F. Kennedy Jr., have defended the rule as protecting children from treatments they argue carry significant long-term risks. The policy does not criminalize gender-affirming care but shifts financial responsibility to states, families, or private insurers.

The rule follows President Donald Trump’s January 2025 executive order directing federal agencies to end federal support for gender-transition procedures involving children. At least 27 states already restrict such care for minors, and the new federal policy could further limit access for low-income transgender youth in states where the treatments remain legal.

Medical groups, including the American Medical Association and American Academy of Pediatrics, oppose the rule, and Democratic state attorneys general and advocacy organizations are preparing legal challenges. The policy is expected to become part of a broader legal and political fight over transgender healthcare in the United States.