JULY 14, 2026
Trump's HHS will not finalize rule that would have cut Medicare and Medicaid funding to hospitals offering trans care to minors
The Department of Health and Human Services will not finalize a proposed rule that would have blocked all Medicare and Medicaid funding to hospitals providing gender-affirming care to minors, according to a document obtained by NPR. The rule was proposed in December and received more than 30,000 public comments before the administration decided against finalizing it. CMS declined to comment on future rulemaking but stated the administration "rejects ideologically driven surgical interventions on vulnerable children."
The Trump administration is not moving forward with what NPR described as its most aggressive attempt to end gender-affirming care for youth nationally. The proposed rule, introduced in December, would have conditioned Medicare and Medicaid participation — and therefore all federal healthcare funding — on hospitals refraining from providing pediatric gender-affirming care. After a 60-day public comment period that drew more than 30,000 responses, HHS has opted not to finalize the rule, at least within the coming year.
The American Medical Association and the Children's Hospital Association both submitted comments urging HHS to rescind the proposal. Major U.S. medical groups have stated that puberty blockers and sex hormones are safe and can be effective for transgender youth. NPR noted in its coverage that surgery is rare among transgender people under age 18, and that the rule as written applied to all gender-affirming care, which is primarily therapy and medications.
Sam Bagenstos, a professor at Michigan Law who served as general counsel at HHS under the Biden administration, told NPR the rule appeared unlawful on several grounds, including that the Medicare Act prohibits using the program to control the practice of medicine within states. He described the use of Medicare and Medicaid "conditions of participation" to prohibit specific treatments for a specific population as unprecedented, noting such leverage has historically been used to enforce basic health and safety standards.