U.S. blocks Medicaid funds for gender-affirming care for minors

The U.S. Department of Health and Human Services (HHS) announced a policy change prohibiting federal Medicaid funding for gender-affirming care provided to low-income minors, effective immediately.

The rule, issued under the Medicaid program, restricts reimbursement for medical interventions such as puberty blockers, hormone therapies, and surgeries when administered to individuals under 18. The restriction applies to all states participating in Medicaid, though individual states may still choose to cover such treatments using state funds.

HHS stated the policy aligns with federal regulations governing Medicaid, which prohibit the use of federal funds for treatments deemed experimental or not medically necessary. The department did not specify whether the rule would extend to adults receiving similar care through Medicaid.

The announcement follows ongoing legal and political debates over gender-affirming care in the U.S., with several states already implementing their own restrictions. The policy change is expected to impact an estimated 3.7 million low-income children enrolled in Medicaid who may have previously accessed such treatments through the program.

Healthcare providers and advocacy groups have criticized the decision, arguing that gender-affirming care is evidence-based and medically necessary for some minors. The rule does not affect private insurance coverage, which remains subject to state and federal regulations.

The HHS did not provide an estimate of the financial impact on Medicaid expenditures or state budgets, which may now bear the full cost of such care if states opt to continue providing it.