U.S. House Speaker Mike Johnson (R-La.) (Washington Blade photo by Michael. Key)
The Republican-led U.S. House of Representatives on May 22 voted 215-214 for passage of the “One Big Beautiful Bill Act” reconciliation package, which includes provisions that would prohibit the use of federal funds to support gender-affirming care.
But for an 11th hour revision of the bill late Wednesday night by conservative lawmakers, Medicaid and CHIP would have been restricted only from covering treatments and interventions administered to patients younger than 18.
The legislation would also drop requirements that some health insurers must cover gender-affirming care as an “essential health benefit” and force states that currently mandate such coverage to find it independently. Plans could still offer coverage for transgender care but without the EHB classification patients will likely pay higher out of pocket costs.
To offset the cost of extending tax cuts from 2017 that disproportionately benefited the wealthiest Americans, the reconciliation bill contains significant cuts to spending for federal programs like Medicaid and the Supplemental Nutrition Assistance Program.
The Human Rights Campaign criticized House Republicans in a press release and statement by the group’s president, Kelley Robinson:
“People in this country want policies and solutions that make life better and expand access to the American Dream. Instead, anti-equality lawmakers voted to give handouts to billionaires built on the backs of hardworking people — with devastating consequences for the LGBTQ+ community.
“If the cuts to programs like Medicaid and SNAP or resources like Planned Parenthood clinics weren’t devastating enough, House Republicans added a last minute provision that expands its attacks on access to best practice health care to transgender adults.
“This cruel addition shows their priorities have never been about lowering costs or expanding health care access–but in targeting people simply for who they are. These lawmakers have abandoned their constituents, and as they head back to their districts, know this: they will hear from us.”
Senate Republicans are expected to pass the bill with the budget reconciliation process, which would allow them to bypass the filibuster and clear the spending package with a simple majority vote.
Changes are expected as the bill will be reviewed and amended by committees, particularly the Finance Committee, and then brought to the floor for debate — though modifications are expected to focus on Medicaid reductions and debate over state and local tax deductions.
