1. United States
2. Utah
3. Letter

On May 22, 2025, the House of Representatives passed H.R. 1, the “One Big Beautiful Bill” Act. H.R. 1 contains provisions that endanger life-saving gender-affirming care for Medicaid enrollees and persons receiving care through Affordable Care Act (ACA) plans. Since 2016, both Medicaid and ACA insurers have been prohibited from categorically excluding gender affirming surgery or hormone therapy from their coverage. H.R. 1 reverses these protections by specifically excluding coverage for gender-affirming care (including surgical and hormonal treatment) from Medicaid coverage. In addition, the bill removes gender-affirming care as an ‘Essential Health Benefit’ required to be provided by ACA policies. These changes in coverage are estimated to affect hundreds of thousands of transgender people throughout the US currently on Medicaid and ACA plans. The research is clear: gender-affirming care saves lives. I’m writing to urge you to oppose any federal appropriations bill that strips funding and access to gender-affirming care. A widespread ban on federal funding will cause hundreds of thousands of transgender Americans to lose access to life-saving health care, and endanger patients, providers and educational institutions across the country.