A critical deadline passed yesterday in the federal fight to preserve transgender people’s access to health care. States and providers have sixty days to respond accordingly.
On August 11, the Trump Administration released a final rule that is set to ban Medicaid and the Children’s Health Insurance Program (CHIP) from covering most kinds of gender-affirming care for trans young people—including some legal adults at age 18. But “final” is different than “enacted,” and it’s not slated to take effect until October.
“Despite this being called a ‘final rule,’ we have time to fight back,” said The Trevor Project’s Vice President, Rodrigo Heng-Lehtinen. “Nothing will change overnight.”
States can offset the rule by subsidizing such care with their own dollars. They could also sue the Administration for what many see as a power grab by Trump officials.
“The rule announced today will face legal challenge,” a press release put out by GLAD Law reads, emphasizing that there is precedent in this arena—and even in the recent past, equal rights groups have scored meaningful victories against the White House on this front.
“Federal courts have blocked previous efforts by the Trump administration to use funding threats to override states’ longstanding authority to regulate medical care, including transgender health care,” it says. “Thus far, Courts have consistently and resoundingly rejected the administration’s efforts to abandon the patients and families who rely on this care.”
The finalized rule does not ban care nationally, nor does it advance Trump’s efforts to ban hospitals from providing these services if they receive Medicaid funds in other areas of practice. It does not change the fact that there is still no federal law restricting gender-affirming care, and in fact, many states have laws explicitly protecting such care.
Ultimately, the rule places the ultimate burden on low-income trans youth and their families, who disproportionately rely on Medicaid services.
The policy is a product of the Centers for Medicare & Medicaid Services, led by television’s Dr. Mehmet Oz, and the Department of Health and Human Services under Robert F. Kennedy Jr.
The rule was first proposed by CMS in February. It was met with swift backlash—nearly 35,000 comments were submitted, the overwhelming majority of them in opposition, the National Women’s Law Center found.
Earlier this year, the courts struck down the so-called Kennedy Declaration, in which the HHS Secretary attempted to restrict health care for trans youth through a “declaration” of what the anti-vaxxer unilaterally determined to be a lack of scientific rigor. But RFK didn’t have the authority to create or enforce the policy, the courts found.
“The notion that ‘I will go forward and issue a declaration and see if we can get away with it’ is not a principle of governance that adheres to the overarching commitment to a democratic republic that requires the rule of law to be regarded and respected and honored as a sacred,” the judge in that case said, as per news reports.
Members of the Congressional Equality Caucus similarly lambasted the proposal when it was first announced, arguing such anti-trans measures “exceed the Centers for Medicare & Medicaid Services (CMS) statutory authority—and set a dangerous precedent of expanding the federal government’s role in the regulation of the practice of medicine,” in a letter sent to Secretary Kennedy.
On Tuesday, Caucus Chair Rep. Mark Takano condemned the final version, too. “In the midst of the Republican Healthcare Crisis, the Trump Administration is once again working to rip access to medically necessary care away from Americans that depend on lifesaving programs like Medicaid and CHIP,” he said.
“Decisions about a young person’s care should be between the patient, their parents, and their provider—not politicians.”
They will come after all of us.
Vote in November as if your life depends on it. Because it might.