The U.S. Department of Health and Human Services (HHS) has finalized a rule to block Medicaid and CHIP funding for gender transition procedures in minors, including cross-sex hormones, puberty blockers, and surgeries.
The Centers for Medicare & Medicaid Services (CMS), an HHS agency, confirmed the decision on Tuesday, stating that taxpayer-funded programs will no longer cover these treatments. The rule applies to both Medicaid and the Children’s Health Insurance Program (CHIP).
HHS spokeswoman Emily Hilliard stated that the action aims to prevent life-altering interventions on minors without sufficient evidence of safety or clinical benefit. The rule was framed as a protection for children from experimental procedures that may pose long-term health risks.
The policy change follows years of debate over whether such treatments should be publicly funded for minors. Supporters argue that the procedures lack rigorous long-term safety data, while critics contend the rule restricts access to necessary care for transgender youth.
What the rule changes
The finalized policy explicitly ends coverage for:
- Cross-sex hormones
- Puberty blockers
- Gender-affirming surgeries
Mental health treatments for gender dysphoria and related conditions will continue to be covered under Medicaid and CHIP, according to CMS.
Rationale from HHS and CMS
HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz both framed the decision as a safeguard for children. Oz stated that the rule follows scientific evidence and protects minors from irreversible harm.
The agencies cited concerns about the lack of reliable long-term studies on the safety and efficacy of these procedures in minors. They also emphasized that the rule aligns with their commitment to protecting children from what they describe as experimental interventions.
Political and public response
The announcement drew immediate reactions from lawmakers and advocacy groups. Some conservative leaders praised the move as a necessary step to prevent taxpayer-funded medical experimentation on children. Others, including LGBTQ+ advocacy organizations, condemned the rule as an attack on transgender youth and a barrier to essential healthcare.
The policy does not affect adult gender transition procedures, which remain eligible for Medicaid and CHIP coverage where medically necessary. The rule is expected to take effect in the coming months, following a public comment period and final implementation steps.