Supreme Court rulings reshape citizenship and federal power
Justice Department correspondent Aysha Bagchi breaks down three major Supreme Court decisions.
The federal agency that runs Medicaid and the Children’s Health Insurance Program will no longer pay for gender-affirming care for minors who don’t identify with the sex they were assigned at birth.
The Department of Health and Human Services announced Aug. 12 that it finalized a rule after more than a year of taking steps to use the federal government’s power to limit this type of medical care.
“We are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies,” President Donald Trump wrote in a social media post.
More than 30 major medical associations and health organizations worldwide support health care for transgender adults and youth, which they say can help prevent suicide in this vulnerable population.
The rule goes into effect Oct. 13 and includes a six-month grace period for children with government insurance who are currently using hormone therapy, according to HHS. It does not affect mental health coverage.
“Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits,” Dr. Mehmet Oz, who runs the Centers for Medicare and Medicaid Services, said in a news release. He said the move is “protecting children from potentially irreversible harm.”
HHS did not say how much federal money it currently spends on surgeries, puberty blockers or hormone therapy, or how many children enrolled in government health insurance are receiving gender-affirming care.
Most gender-affirming care is sought by young adults, not children, but as many as one in four people getting this type of care are covered by Medicaid.
Rep. Mark Takano, a Democrat who chairs the Congressional Equality Caucus, called the move “another cruel, overreaching attack” on transgender youth.
“Decisions about a young person’s care should be between the patient, their parents, and their provider – not politicians,” Takano wrote.
Trump first took action against gender-affirming care for minors with an executive order in January 2025. In April 2025, Oz told states not to use Medicaid funding for surgeries or hormone treatment.
In December, HHS Secretary Robert F. Kennedy Jr. announced his department was beginning an administrative process to end funding for hospitals who provide gender-affirming surgeries.
The Food and Drug Administration, which regulates medical devices, also sent warning letters to manufacturers of breast binders telling them not to market their devices to children with gender dysphoria.
Contributing: Ken Alltucker, USA TODAY