House passes tax bill that would ban Medicaid from covering transition-related care

The House tax bill would prohibit Medicaid from covering any transgender health care, for both minors and adults.

The tax bill the House passed Thursday would bar Medicaid coverage of all transgender care and prohibit plans offered under the Affordable Care Act’s exchanges from covering such care as an essential health benefit, potentially jeopardizing access to care for hundreds of thousands of trans adults and an unknown number of minors.

The bill initially would have prohibited Medicaid from covering “gender transition procedures” for minors, including puberty blockers, hormone therapy and surgery. However, House Republican leadership introduced an amendment late Wednesday that struck the word “minors” and the words “under 18 years of age” from that section, The Independent first reported.

The amendment passed the GOP-led House Rules Committee on Wednesday night before the full House passed it Thursday morning.

Another part of the bill would prohibit transition-related medical care as an essential health benefit under health care plans offered through the Affordable Care Act’s marketplace. Essential health benefits packages vary by state but are required by federal law to cover 10 categories of benefits. Nearly half of states have prohibited health insurance providers from explicitly refusing to cover transition-related care.

The tax bill’s prohibitions could have a significant effect on hundreds of thousands of trans adults in the U.S. A report published this month by the Williams Institute at UCLA School of Law found that about 180,000 trans adults use Medicaid as their primary insurance. Another study, published in 2023, found that nearly 1 in 4 (24.6%) trans adults are on Medicaid, or about 312,000, based on one estimate that there are 1.3 million trans adults in the U.S.