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After days of<\/span> infighting over Trump\u2019s \u201cBig, Beautiful Bill,\u201d the House GOP passed reconciliation legislation in the dead of the night \u2014 with one major giveaway to the far-right. Late Wednesday, Congressional Republicans amended the bill to prohibit the use of Medicaid funding for gender-affirming care, potentially ripping healthcare access away from hundreds of thousands of transgender Americans.\u00a0<\/p>\n An earlier version of the legislation targeted Medicaid funding for gender-affirming care for minors. In a midnight-hour maneuver, Republicans removed the word \u201cminors\u201d<\/a> from that provision, prohibiting the use of Medicaid funding for \u201cgender-transition procedures\u201d for children as well as adults.\u00a0<\/p>\n The legislation broadly defines<\/a> \u201cgender-transition procedures\u201d as everything from surgery to hormone therapy. It needs only a simple majority to pass the Senate.<\/p>\n Experts on transgender health care said that if this provision advances, it could make an already-dire landscape for transgender care significantly worse. They described devastating consequences for the hundreds of thousands of transgender Americans who rely on Medicaid that will be further compounded by the roughly $700 billion in cuts<\/a> to the health program in the GOP bill.\u00a0<\/p>\n <\/p>\n <\/p>\n \u201cTrans folks are more likely to be lower income and subsequently more likely to qualify for [Medicaid],\u201d said Aspen Ruhlin, community manager at the Mabel Wadsworth Center in Bangor, Maine, which provides LGBTQ+ care, including gender-affirming hormone therapy, as well as abortion care and other health care services. \u201cThis would have a devastating impact on folks, as they would lose coverage for what is normal and needed health care.\u201d\u00a0<\/p>\n \u201cThere\u2019s not good coverage to begin with.\u201d<\/p>\n<\/blockquote>\n<\/figure>\n \u201cWe have seen that in states that have fought to ban gender-affirming care. They always start with minors and then \u2026 trojan horse it into banning coverage for or banning access to gender-affirming care generally,\u201d they said.\u00a0<\/p>\n According to a 2022 report from the Williams Institute at the UCLA School of Law, roughly 276,000 transgender adults<\/a> are enrolled in Medicaid in the United States. Even without the new legislation, accessing gender-affirming care is incredibly difficult. According to the Williams Institute report, 38,000 transgender adults<\/a> with Medicaid live in states that expressly deny access to gender-affirming care, and 74,000 transgender<\/a> Medicaid beneficiaries live in states without laws explicitly protecting coverage.\u00a0<\/p>\n \u201cThere\u2019s not good coverage to begin with,\u201d said Dr. Lakshmi Sundaresan, a family medicine physician in Michigan who provides gender-affirming services but not surgery. \u201cWe are often already fighting this uphill battle for coverage.\u201d\u00a0\u00a0<\/p>\n Sundaresan argued that GOP lawmakers are trying to pretend as if gender-affirming care is a financial burden on the United States, even as they cut basic services for the overwhelming majority of Americans to grant generous tax cuts for the wealthy<\/a>.\u00a0<\/p>\n \u201cThe impacts of those large scale cuts are going to be felt by the lay public, because they\u2019re going to lose coverage, or people are going to basically become bankrupt over time if they have prolonged hospitalizations,\u201d she said.\u00a0<\/p>\n <\/p>\n\n