Republican Reps. Marjorie Taylor Greene of Georgia and Thomas Massie of Kentucky hold a news conference against House Speaker Mike Johnson on May 1, 2024.
Reps. Marjorie Taylor Greene (R-GA) and Dan Crenshaw (R-TX) have introduced a bill to ban Medicaid from covering all gender-affirming care for transgender minors, including puberty blockers, hormone therapy, and surgery, The Center Square reports. Republicans are claiming that the bill should be seen as a narrow fiscal matter, meaning that it could bypass the Senate filibuster and become law more easily.
“Using Medicaid funds for unproven and irreversible procedures on minors is not only medically irresponsible but also a betrayal of public trust,” Crenshaw said in a statement after filing the “Do No Harm in Medicaid Act.” “This bill ensures that Medicaid’s limited resources are used only for evidence-based, medically necessary care.”
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Moreover, what Medicaid covers is determined by states in accordance with federal guidelines. Crenshaw didn’t explain why so many states are covering gender-affirming if there really is no evidence to support its efficacy or why federal intervention would be needed to specifically prohibit these treatments and only for a subset of people seeking them.
He said the bill contains exceptions for cisgender people to get gender-affirming care under some circumstances.
The LGBTQ+ rights organization HRC denounced the bill.
“Everyone deserves the freedom to make deeply personal health care decisions for themselves and their families–no matter your income, zip code, or health coverage,” HRC President Kelley Robinson said in a statement to LGBTQ Nation. “This bill is a brazen attempt to put politicians in between people and their doctors, preventing them from accessing evidence-based healthcare supported by every major medical association in the country. It is unfair to make people on Medicaid have to pay out of pocket for this care simply because they have government-funded health insurance. Questions about this care should be answered by doctors–not politicians–and decisions must rest with families, doctors, and the patient.”
Republicans now control majorities in both the House and the Senate, and Speaker Mike Johnson (R-LA) has made his opposition to gender-affirming care clear in the past, claiming that kids aren’t transgender but instead are being turned transgender by their parents.
“A parent has no right to sexually transition a young child,” he said in 2023.
Usually, the Senate’s requirement for 60 votes to end a filibuster has been a significant roadblock to legislation passing Congress in the past. Republicans hold 53 seats in the Senate so they will need at least seven Democratic votes over the next two years to pass legislation.
But Crenshaw says that the bill is narrowly tailored to get through the Senate using the reconciliation process, which is a loophole reserved for certain fiscal bills. Only a simple majority – or 51 votes, or 50 votes plus the vice president as a tie-breaker – are needed to pass legislation under reconciliation.
“Budget reconciliation provides a unique opportunity to pass meaningful reforms with direct fiscal impacts,” he said. “This bill fits squarely within that framework, ensuring it will survive procedural scrutiny while delivering a critical win for children and families.”
Donald Trump could sign it into law. He promised his followers an end to federal support for gender-affirming care “at any age” and campaigned heavily on opposition to government funding for gender-affirming care in prisons.
The bill is, effectively, a narrower version of Rep. Greene’s “Protect Children’s Innocence Act,” which she has filed in the past two sessions of Congress and repeatedly advocated for over the last several years. That bill would ban transgender health care for minors entirely, make it harder for transgender adults to get such health care, and ban medical schools from teaching about it.
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