The proposal, which was first detailed in the Wall Street Journal, could harm transgender people even in blue states if it becomes part of the negotiated deal.
This is why I’m running for United States House of Representatives Wisconsin District 8. There’s numerous reasons I’m running, but this sort of discriminatory policy and treatment is the most urgent. I’ve really had enough of it, and I know y’all have too.
I propose a provision be added we remove all healthcare coverage for GOP members of the House. Let’s see how neat THEY think it is.
Democrats should not sign off on any bill that restricts gender affirming care even if they have to close down the government again. This time no giving in to promises or any republican bullshit. We either we get what the citizens of our country deserve or we do not allow anything to go forward period.
There is no specific, consistent percentage of total Affordable Care Act (ACA) spending attributed solely to transgender individuals available in public data.
Instead of a specific percentage, the available data highlights that:
Transgender individuals are more likely to be uninsured or rely on public insurance programs like Medicaid due to various socioeconomic factors, including discrimination. Approximately 21% of transgender adults rely on Medicaid, compared to about 16% of cisgender, straight adults.
The actual cost of covering gender-affirming care (GAC) is a very small fraction of overall health expenditures. An actuarial analysis in Colorado, for example, found the cost impact of adding GAC to the Essential Health Benefits (EHBs) benchmark plan was only about 0.04%.
The ACA generally prohibits discrimination, which has been leveraged to require coverage for medically necessary GAC. However, coverage of specific services as EHBs is determined at the state level, leading to significant variation.
Recent legislative proposals in the U.S. House have aimed to explicitly exclude GAC from federal Medicaid funding and from being considered an EHB under the ACA, suggesting that this spending is currently a topic of political debate rather than a major budget item.
Thanks for your research, Jeanne. I was going to point out that with our small population GAC is surely a rounding error in the scheme of things. Your work confirms that. As far as EHBs go, let's see how the haters like a hormone balance that their brain rejects. For years I've called estrogen a life-saving miracle drug. But of course the cruelty is the point, as it so often is.
Subject: Please Oppose Any ACA Deal That Strips Transgender Health Care Coverage
Representative Carbajal,
Thank you again for your continued leadership, and for taking the time to meet with me in the past. I also want to sincerely thank you for signing the recent letter condemning the use of anti-trans slurs on the House floor. I hope to see those standards actually enforced. Our democracy is weaker when hate speech is normalized inside its most powerful chamber.
I’m writing with urgency regarding the newly reported negotiations around ACA subsidies. As you know, some Republicans are now pushing for Hyde-style restrictions that would bar subsidized plans from covering gender-affirming care. Such a policy would be devastating. It would strip transgender people, including many in our district, of medically necessary, evidence-based care, even in states like California that have enacted strong protections. Creating a federal carve-out would undermine state law, destabilize care, and further marginalize a community that is already under direct political attack.
Representative Carbajal, I’m asking you to reject any deal, amendment, or negotiated package that includes restrictions on gender-affirming care. There is no compromise to be made on whether transgender people deserve access to basic health care. These riders are cruel by design, and they must not be normalized as bargaining chips in appropriations negotiations.
We need steadfast clarity now more than ever. Please commit to voting no on any ACA subsidy extension or appropriations bill that includes anti-trans provisions, no matter how they are framed or packaged.
Thank you again for your time, your attention, and your ongoing willingness to engage with the community. I look forward to continuing to work together to protect the rights, dignity, and health of transgender people in our district and across the country.
The gop isn’t going to accept a deal anyways. The republicans in congress have already indicated too much opposition to save ACA subsidies (another reason MTG left, as she found herself defending *obamacare* against conservatives)
They’re just going to try to reframe it as about trans people so we get blamed for something rightwingers were already going to do anyways. And the cult will eat it up
I'm still curious about who the Dem representatives are who did not sign the letter condemning anti-trans speech from members of the House. Whoever they are, we can't trust them and I'd expect them to fully throw us under the bus when these anti-trans provisions are in any bill.
The current political party count in the House is 219R - 213D. Erin’s article is reporting 213 Democrats signed off on the letter, so that should be everyone. If true, it is more evidence of the strong cultural split on the issue between the GOP and the Democrats, which can serve as some measure of protection.
But does the letter by the 213 Democrats indicate their calculation that there is no political cost to be paid for supporting trans people? That would be consistent with recent polling (which EITM has been reporting) and also with the results of the last election. But it would seem to be inconsistent with the conventional wisdom that Harris lost because of all the anti-trans advertising. But is that true? Massive anti-trans advertising could surely have made a decisive marginal difference in a close race. But true anti-trans sentiment, in the general population, is surely not as widespread as the impression created by the propagandists and sensationalists.
One of the things I point out to anyone that will listen is that these people have no stopping point. They’ve already succeeded in ruining passports for trans people, which is the single most valuable federal ID document. So are they satisfied now? No. Bullies never are. If the anti-trans riders don’t get approved this go-round, be assured they will keep trying again and again until they do. Why can’t Democrats exhibit the same resilience in defending trans people?
These people who think that the Republicans are going to change their minds about the Trans Community are delusional! They will Never stop hating on our communities because they don’t want any of us to exist! THEY WILL NOT CHANGE EVER! They want a White Nationalist Country that is nothing but a White Boys only club and they would prefer that No people of color were in the country! Or LGBTQIA+ were in the country! And they want Women to be treated as property again!
Look in the Mirror you Ignorant Idiots and you will see the image that you HATE more than anything else in your Miserable existence! 👿
"Fraud protections" can easily include verification that sex at birth corresponds with the indicated sex of the named beneficiary, and that the health care being provided is "sex-appropriate."
On another point, Erin writes: "Some Republicans are seeking a Hyde Amendment–style provision that would bar federal dollars from covering gender-affirming care or abortion in subsidized plans."
This is further evidence that trans rights and abortion rights and reproductive rights generally are fully joined in the minds of those who would deny us those rights, and the politics of securing those rights must be similarly joined analytically, strategically, tactically, and rhetorically, by those who want those rights secured.
The decadeslong estrangement between trans and feminist politics continues to haunt and hold us back. A "trans Hyde amendment" is just a matter of time. As is the dusting off of Comstock.
I called both of my spineless Democratic senators, who voted to strip Tricare gender affirming care coverage for trans family members in the first NDAA. I told them that trans people are POOR, and most of us wouldn't even have health insurance coverage, were it not for the ACA. I said that we commonly work multiple part time jobs or work in the gig economy, so most of us don't have employer-sponsored insurance like other folks. And we are at the low end of the income scale. To take health benefits away from the poor to give subsidies to those in higher income brackets is IMMORAL. I asked that they counter the Republican proposal with a demand that Tricare coverage for gender affirming care be restored. No more of this slippery slope shit.
' ... The Wall Street Journal reports that one Republican being pushed by some Republicans is a demand to strip transgender health care from plans receiving ACA subsidies ... '
Umm, what? What word should be there in place of the first occurrence of 'Republican' ?
This is why I’m running for United States House of Representatives Wisconsin District 8. There’s numerous reasons I’m running, but this sort of discriminatory policy and treatment is the most urgent. I’ve really had enough of it, and I know y’all have too.
I propose a provision be added we remove all healthcare coverage for GOP members of the House. Let’s see how neat THEY think it is.
I knew the lack of amendments towards us was too good to be true :/
Democrats should not sign off on any bill that restricts gender affirming care even if they have to close down the government again. This time no giving in to promises or any republican bullshit. We either we get what the citizens of our country deserve or we do not allow anything to go forward period.
There is no specific, consistent percentage of total Affordable Care Act (ACA) spending attributed solely to transgender individuals available in public data.
Instead of a specific percentage, the available data highlights that:
Transgender individuals are more likely to be uninsured or rely on public insurance programs like Medicaid due to various socioeconomic factors, including discrimination. Approximately 21% of transgender adults rely on Medicaid, compared to about 16% of cisgender, straight adults.
The actual cost of covering gender-affirming care (GAC) is a very small fraction of overall health expenditures. An actuarial analysis in Colorado, for example, found the cost impact of adding GAC to the Essential Health Benefits (EHBs) benchmark plan was only about 0.04%.
The ACA generally prohibits discrimination, which has been leveraged to require coverage for medically necessary GAC. However, coverage of specific services as EHBs is determined at the state level, leading to significant variation.
Recent legislative proposals in the U.S. House have aimed to explicitly exclude GAC from federal Medicaid funding and from being considered an EHB under the ACA, suggesting that this spending is currently a topic of political debate rather than a major budget item.
Thanks for your research, Jeanne. I was going to point out that with our small population GAC is surely a rounding error in the scheme of things. Your work confirms that. As far as EHBs go, let's see how the haters like a hormone balance that their brain rejects. For years I've called estrogen a life-saving miracle drug. But of course the cruelty is the point, as it so often is.
Subject: Please Oppose Any ACA Deal That Strips Transgender Health Care Coverage
Representative Carbajal,
Thank you again for your continued leadership, and for taking the time to meet with me in the past. I also want to sincerely thank you for signing the recent letter condemning the use of anti-trans slurs on the House floor. I hope to see those standards actually enforced. Our democracy is weaker when hate speech is normalized inside its most powerful chamber.
I’m writing with urgency regarding the newly reported negotiations around ACA subsidies. As you know, some Republicans are now pushing for Hyde-style restrictions that would bar subsidized plans from covering gender-affirming care. Such a policy would be devastating. It would strip transgender people, including many in our district, of medically necessary, evidence-based care, even in states like California that have enacted strong protections. Creating a federal carve-out would undermine state law, destabilize care, and further marginalize a community that is already under direct political attack.
Representative Carbajal, I’m asking you to reject any deal, amendment, or negotiated package that includes restrictions on gender-affirming care. There is no compromise to be made on whether transgender people deserve access to basic health care. These riders are cruel by design, and they must not be normalized as bargaining chips in appropriations negotiations.
We need steadfast clarity now more than ever. Please commit to voting no on any ACA subsidy extension or appropriations bill that includes anti-trans provisions, no matter how they are framed or packaged.
Thank you again for your time, your attention, and your ongoing willingness to engage with the community. I look forward to continuing to work together to protect the rights, dignity, and health of transgender people in our district and across the country.
With appreciation,
Michelle Rosenblum (she/her)
Ventura, CA
Thank you for sharing this! Is it ok to copy this & distribute it as a template for others?
Absolutely! Share far and wide - we must keep up the pressure.
The gop isn’t going to accept a deal anyways. The republicans in congress have already indicated too much opposition to save ACA subsidies (another reason MTG left, as she found herself defending *obamacare* against conservatives)
They’re just going to try to reframe it as about trans people so we get blamed for something rightwingers were already going to do anyways. And the cult will eat it up
I'm still curious about who the Dem representatives are who did not sign the letter condemning anti-trans speech from members of the House. Whoever they are, we can't trust them and I'd expect them to fully throw us under the bus when these anti-trans provisions are in any bill.
I think I may be missing a few but I did not see these 3 dems on the letter:
Henry Cuellar (TX 28)
Vinciente Gonzales (TX 34)
Adam Gray (CA 13)
The current political party count in the House is 219R - 213D. Erin’s article is reporting 213 Democrats signed off on the letter, so that should be everyone. If true, it is more evidence of the strong cultural split on the issue between the GOP and the Democrats, which can serve as some measure of protection.
But does the letter by the 213 Democrats indicate their calculation that there is no political cost to be paid for supporting trans people? That would be consistent with recent polling (which EITM has been reporting) and also with the results of the last election. But it would seem to be inconsistent with the conventional wisdom that Harris lost because of all the anti-trans advertising. But is that true? Massive anti-trans advertising could surely have made a decisive marginal difference in a close race. But true anti-trans sentiment, in the general population, is surely not as widespread as the impression created by the propagandists and sensationalists.
One of the things I point out to anyone that will listen is that these people have no stopping point. They’ve already succeeded in ruining passports for trans people, which is the single most valuable federal ID document. So are they satisfied now? No. Bullies never are. If the anti-trans riders don’t get approved this go-round, be assured they will keep trying again and again until they do. Why can’t Democrats exhibit the same resilience in defending trans people?
These people who think that the Republicans are going to change their minds about the Trans Community are delusional! They will Never stop hating on our communities because they don’t want any of us to exist! THEY WILL NOT CHANGE EVER! They want a White Nationalist Country that is nothing but a White Boys only club and they would prefer that No people of color were in the country! Or LGBTQIA+ were in the country! And they want Women to be treated as property again!
Look in the Mirror you Ignorant Idiots and you will see the image that you HATE more than anything else in your Miserable existence! 👿
This is despicable, and i'm not at all surprised. I guess we'll see if the Democrats will stand behind us or if cave. I'm not holding my breath.
God forbid the republicans spent any time at all not trying to throw us under a bus
There's no defensible rationale here; it's culture war bigotry. Thank you for the reporting.
Such pettiness and cruelty.
Contact your elected representatives and protest loudly.
"Fraud protections" can easily include verification that sex at birth corresponds with the indicated sex of the named beneficiary, and that the health care being provided is "sex-appropriate."
On another point, Erin writes: "Some Republicans are seeking a Hyde Amendment–style provision that would bar federal dollars from covering gender-affirming care or abortion in subsidized plans."
This is further evidence that trans rights and abortion rights and reproductive rights generally are fully joined in the minds of those who would deny us those rights, and the politics of securing those rights must be similarly joined analytically, strategically, tactically, and rhetorically, by those who want those rights secured.
The decadeslong estrangement between trans and feminist politics continues to haunt and hold us back. A "trans Hyde amendment" is just a matter of time. As is the dusting off of Comstock.
I called both of my spineless Democratic senators, who voted to strip Tricare gender affirming care coverage for trans family members in the first NDAA. I told them that trans people are POOR, and most of us wouldn't even have health insurance coverage, were it not for the ACA. I said that we commonly work multiple part time jobs or work in the gig economy, so most of us don't have employer-sponsored insurance like other folks. And we are at the low end of the income scale. To take health benefits away from the poor to give subsidies to those in higher income brackets is IMMORAL. I asked that they counter the Republican proposal with a demand that Tricare coverage for gender affirming care be restored. No more of this slippery slope shit.
' ... The Wall Street Journal reports that one Republican being pushed by some Republicans is a demand to strip transgender health care from plans receiving ACA subsidies ... '
Umm, what? What word should be there in place of the first occurrence of 'Republican' ?