1. United States
2. Mich.
3. Letter

I am writing to urge you to reject any restrictions on transgender healthcare that may be included in ongoing healthcare negotiations, particularly those proposed by Senate Republicans Mike Crapo and Bill Cassidy in their recent ACA plan. The Republican proposal contains three sweeping restrictions that would devastate access to medically necessary care: barring Health Savings Accounts from treating gender-affirming care as medically necessary, preventing ACA plans from classifying gender-affirming care as an essential health benefit, and banning Medicaid from covering transgender healthcare entirely. While this specific proposal may lack a clear path to passage, its introduction establishes transgender healthcare restrictions as a Republican negotiating position for future legislative discussions. These restrictions would have catastrophic consequences for transgender Americans who rely on insurance coverage for essential medical care. While some transition-related medications are generic and affordable, required lab work and surgeries become prohibitively expensive without insurance coverage. Loss of healthcare access directly correlates with increased suicidality and mental health crises in the transgender community. I am asking you to firmly oppose any compromise that includes restrictions on transgender healthcare. This is not a bargaining chip. Recent elections demonstrate that voters are exhausted by anti-trans messaging. Abigail Spanberger in Virginia and Mikie Sherrill in New Jersey both won their races despite heavy Republican spending on anti-trans advertising, showing this issue does not resonate with voters as Republicans hoped. Democrats have successfully blocked similar provisions in the House, the big beautiful bill, continuing resolutions, and the NDAA. I need you to continue this strong defense of transgender rights and reject any attempt to use healthcare access as a negotiating tool. Transgender people deserve the same access to medically necessary care as all Americans, and I expect you to stand firm on this principle in all upcoming healthcare negotiations.