Trump admin eyes insurance cuts to hospitals offering trans care for youth
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Transgender flags during the 25th Anniversary Kentuckiana Pride Festival in June. Photo by Stephen J. Cohen/Getty Images.
Trump health officials are considering a policy that would limit hospitals' ability to participate in Medicare and Medicaid if they perform gender-affirming medical procedures for transgender youth.
The big picture: Hospitals are highly dependent on payment from public health insurance.
- Medicare and Medicaid covers at least two-thirds of inpatient days at more than 80% of hospitals, according to a 2024 report from the American Hospital Association.
State of play: The proposed policy change landed at the White House for review on Thursday, according to the Office of Information and Regulatory Affairs' website.
- The rule is expected to prevent hospitals that provide gender-affirming procedures for minors from getting paid by Medicare or Medicaid, the National Review reported on Thursday.
- Stakeholders — including the National Women's Law Center and the Illinois attorney general's office, both which have advocated for gender-affirming care for youth — have scheduled meetings with administration officials to discuss the policy before it is officially proposed.
Trump administration health officials didn't respond to questions about which procedures or services would be prohibited for Medicare and Medicaid-participating hospitals.
- It's not clear when the administration aims to phase in the change.
- The Centers for Medicare and Medicaid Services told Axios that it doesn't comment on potential future regulations but that future CMS actions will continue to support President Trump's executive order to defund gender-affirming care for minors.
- That order has been temporarily blocked in court.
Zoom out: Many hospitals — even in deep-blue states — have already pulled back from providing transition-related services for minors over fear of losing federal funding based on previous Trump administration actions.
- 16 states last week sued the administration over the funding threat and other actions, including investigations of hospitals and demands for patient data, saying they amounted to an attempt to enforce a nationwide ban on transgender care.
Reality check: Gender-affirming medical care for kids with gender dysphoria is supported by major medical organizations including the American Medical Association.
- Drugs like puberty blockers are temporary and reversible and used for both trans and non-trans youth who experience early onset puberty. Surgeries for transgender children are rare, and research shows that most people who get transition-related care as adolescents are satisfied with that decision as adults.
