The Centers for Medicare and Medicaid Services finalized a rule on August 11, 2026 that bars federal Medicaid dollars from covering gender-affirming surgeries and hormone treatments for transgender minors, with the policy set to take effect October 13, 2026.
The rule blocks federal Medicaid funding for what the agency calls “s*x-rejecting procedures for children under 18,” and prohibits the Children’s Health Insurance Program from paying for the same procedures for people under 19. Beneficiaries currently receiving cross-s*x hormone therapy can keep claiming benefits for up to six months after the effective date, and the rule does not affect coverage of mental health treatment for transgender youth. President Trump directed Dr. Mehmet Oz, the CMS administrator, to make the change, writing on social media that “we are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies.”
Health Secretary Robert F. Kennedy Jr. said the rule was ending “federal taxpayer funding for s*x-rejecting procedures on children,” adding that the interventions “carry serious risks and can cause irreversible harm.” CMS says the decision follows a review of national and international research that it concluded left insufficient evidence to justify federal funding. States can still choose to cover the procedures using their own dollars.
Nearly 35,000 public comments were submitted on the proposed rule, with over 90 percent of commenters opposing it, many of them parents of transgender children. LGBTQ rights organizations have said they plan to challenge the rule in court, with GLBTQ Legal Advocates and Defenders stating the rule “will face legal challenge,” while noting it would not ban the care nationally or bar hospitals from providing it.
