1. United States
2. Mich.
3. Letter

I urge you to oppose HB498, the so-called Do No Harm in Medicaid Act, which would prohibit federal Medicaid funding for gender transition procedures for individuals under eighteen years old. This legislation would deny medically necessary healthcare to vulnerable young people, creating dangerous barriers to treatment that major medical organizations recognize as essential. HB498 would eliminate Medicaid coverage for a comprehensive range of treatments including puberty-blocking medications, hormone therapy, and surgical interventions. Given that Medicaid covers approximately forty percent of children in the United States, with higher percentages among low-income families, this funding prohibition creates an insurmountable financial barrier for the families who can least afford it. The bill creates disparate access to care based solely on insurance status, allowing privately insured minors to potentially retain coverage while denying the same care to low-income youth. This legislation directly contradicts established medical guidelines from major professional organizations and interferes with medical decision-making between patients, families, and healthcare providers. The categorical exclusion of coverage for gender transition procedures while maintaining coverage for other medically necessary treatments constitutes impermissible discrimination against transgender youth. Courts increasingly recognize transgender individuals as a protected class, and HB498's approach may violate equal protection principles. The real-world consequences of this bill are severe. Denying access to care will likely increase mental health crises among transgender youth, drive higher emergency department utilization for complications from self-administered treatments, and push care to unregulated providers. The bill contains no transition period for minors currently receiving treatment, creating immediate disruption to ongoing care relationships and treatment protocols. I ask you to oppose HB498 and protect the ability of families and medical professionals to make healthcare decisions based on medical evidence rather than political considerations. Transgender youth deserve access to the same standard of care as all other children.