House Votes 215–201 to Bar Medicaid Funding for Gender Transition Care for Minors

The U.S. House of Representatives on December 18, 2025, passed the Do No Harm in Medicaid Act, a bill that would prohibit federal Medicaid payment for specified gender transition procedures for people under the age of 18. The vote was 215 to 201, with 17 members not voting.

The measure, H.R. 498, amends the Social Security Act to bar federal Medicaid funding for procedures intended to change the body of a minor so that it no longer corresponds to the individual's biological sex. The bill lists specified surgeries, implants, and medications — including puberty-blocking drugs and hormones such as testosterone and estrogen — as covered by the prohibition. It excludes procedures provided with the consent of a parent or guardian that are intended to treat conditions such as early-onset puberty, genetic disorders of sex development, or complications from prior procedures, or to prevent imminent death or impairment of a major bodily function. The lead sponsor is Representative Dan Crenshaw of Texas, who introduced the bill with Representative Marjorie Taylor Greene of Georgia. The Congressional Budget Office estimated the bill would save taxpayers $445 million over a decade.

Supporters argued that the procedures are harmful to children and that taxpayer money should not pay for them. Representative Brett Guthrie of Kentucky, who managed the bill on the floor, said it "prohibits Federal dollars from going toward specified gender transition procedures for individuals under 18" and "in no way prevents minors from accessing medical care that they truly need." Crenshaw said the bill "simply says that your tax dollars won't allow this to be done on minors" and argued that "the highest quality medical reviews have consistently found no clear evidence that puberty blockers, cross-sex hormones, or surgeries reduce suicide risk in minors." Representative Mike Kennedy of Utah, a physician, urged colleagues "to follow the scientific evidence and stop funding these horrific procedures on kids."

Opponents argued the bill interferes in private medical decisions and discriminates against transgender youth. Representative Frank Pallone of New Jersey said Republicans were "reaching into the doctor's office and taking deeply personal and private medical questions out of the hands of doctors, parents, and patients," and noted the bill would also bar states from using their own funds to cover the care. Representative Mark Takano of California said the bill "prohibits Medicaid from spending funds on medically necessary care" and "bans Medicaid from covering medical care for transgender youth but allows for the same exact care for nontransgender youth." Opponents also entered into the record a letter from the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, and the American Psychiatric Association opposing the bill.

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