Some House Republicans are pushing ahead with a bill to cut off access to health care for transgender and nonbinary people — and this year, with a GOP majority in the chamber, the policy could get a vote, Maya and Victoria report.

Why it matters: Although the legislation would likely die in the Senate, if it gets a vote on the House floor it sets the stage for Republicans to take a national stance on gender-affirming care, an issue that has already been playing out in states.

Driving the news: Last week, Rep. Marjorie Taylor Greene reintroduced the Protecting Children’s Innocence Act, which would make performing gender-affirming care on minors a felony. It's one of the first federal bills this Congress that would ban transgender medical care.

• The bill would also affect trans adults by essentially banning Medicare, Medicaid and Affordable Care Act health plans from providing gender-affirming care and prohibiting medical schools from training providers to offer gender-affirming care.
• The legislation garnered 49 co-sponsors last Congress but never had a hearing, despite being referred to four committees.

Reality check: Professional medical associations recommend that transgender children and adolescents receive early gender-affirming care, and what that looks like varies on a case-by-case basis.

• Most care options — including social affirmation, puberty blockers and hormone therapy — are reversible or partially reversible and take place over an extended period of time, although hormone therapy can have some permanent effects.
• Proponents of the bill argue it would safeguard kids from making life-altering decisions. “We're, as leaders, protectors for these innocent children,” said Rep. Diana Harshbarger, a co-sponsor.
• But for the estimated 1.4% of teens ages 13 to 17 who identify as trans, gender-affirming care can be a life saver: A 2022 study found gender-affirming care to be associated with 60% lower probability of depression and 73% lower probability of suicidality in teenagers.
• Existing medical guidelines typically advise surgical interventions just for adults, though they are sometimes recommended for adolescents on a case-by-case basis.

What they’re saying: Having lawmakers debate whether LGBTQ people should receive health care “can have harmful mental health consequences even if it doesn’t become law,” said Sarah Warbelow, legal director for the Human Rights Campaign.

Go deeper: More than 100 anti-trans health care bills have been introduced in state legislatures this year, according to the American Civil Liberties Union.

• Greene’s bill is just one anti-trans bill introduced in Congress this year: The House Education & the Workforce Committee already held a hearing on a bill to prevent trans girls from playing on women’s and girls’ school sports teams. Sen. Josh Hawley introduced a bill in February that would make it a civil liability to perform gender-affirming care on minors.

Worth noting: There isn’t consensus in the Republican party, or even among its most conservative members, that Congress should weigh in on gender-affirming care.

• House Freedom Caucus chair Rep. Scott Perry called gender-affirming care for children "child abuse."
• “But I also don’t know if it’s the role of the federal government as opposed to the states,” Perry added.
• “I want to see Congress take less initiative in American peoples’ lives,” Rep. George Santos said when asked if he’d support the bill.
• Still, “I think a lot of members support this,” said Rep. Kevin Hern, chair of the Republican Study Committee, and a co-sponsor.

What’s next: Greene told Axios she presented the bill to the Republican Study Committee and House Freedom Caucus. She hopes to see the bill passed on its own rather than attached to an annual appropriations bill or other legislative vehicle.

• But Speaker Kevin McCarthy’s office didn’t respond to Axios’ request for comment on whether the bill would receive a floor vote, and committees haven’t said they’ll hold hearings on the bill yet, either.

Asked if she’d be willing to hold up the passage of other legislation to get her bill through the House, Greene said she hadn’t thought about it.

• Rep. Pramila Jayapal, chair of the Congressional Progressive Caucus and the parent of a transgender daughter, told Axios she has a “deep commitment” to making sure Greene’s bill and similar proposals do not pass the House.

Welcome back to Lunch with a Lobbyist! This week, Maya sat down with Krista Drobac, a partner at Sirona Strategies, for lunch at Unconventional Diner. (Drobac got the Lebanese fried rice and a decaf coffee.)

• Before co-founding Sirona, Drobac held several roles across the health policy landscape, including at the National Governors Association, at CMS, and in Sen. Dick Durbin’s office.

Best Capitol Hill celebrity sighting: I am a policy and political nerd, so I think of politicians as celebrities. Watching Sens. Ted Kennedy and Orrin Hatch at work when I was on the Hill in the early 2000s was pretty cool. They were both at the center of so many health policy breakthroughs.

• I was able to spend a fair amount of time with [Kennedy] during the debate over the Medicare drug benefit in 2003, and he and Sen. Durbin would write notes to each other on the floor.
• At the end, Durbin let me keep the notes, and I just thought, wow, this is like a piece of history.

Best health care negotiator: Nancy Pelosi. No one says no to Nancy Pelosi, and she’s also very reasonable. She will take your input on policy and also on what you need for your district and not just twist your arm but actually try to give you something to vote for.

• I worked in the Obama administration during the ACA, and we saw what she did almost singlehandedly.

Between working in the administration, on the Hill and as a lobbyist, what’s your favorite? I love being a lobbyist. My dad wants me to tell the family that I’m a consultant because he’s embarrassed that I’m a lobbyist! But I believe in everything that I’m advocating for.

• I get more done as a lobbyist than I was able to on Capitol Hill or in the administration, not because they can't do a lot but because I'm driving forward in a way that I don't have to ask for permission as much.

What’s your health policy hot take? My current frustration and hot take is that we are going completely backwards on moving more seniors into the home. And it's exactly the same time that I'm witnessing my own mother resisting going to an institutional facility.

• We do have some champions now on Capitol Hill. But we have further to go than I would have thought [following the pandemic].

What’s your favorite nonpolitical thing about D.C.? The evolution of the food scene here!

• When I first moved here in the '90s, the only places that you could eat were steak places. It was like, pick your steak place.
• I moved to Chicago in 2006 and I remember my first thought was just, there are so many interesting restaurants here. When I moved back to D.C. — when 14th Street started getting really developed and as Shaw and Logan Circle got more developed — the food scene got a lot more interesting.
• Her restaurant favorites: If I’m with my husband and we’re just going for ourselves, I would say Rasika. With the kids, it’s Commissary in Logan Circle.