Oppose HHS Rule Banning Gender-Affirming Care Through Medicaid Participation

I am writing to urge you to take immediate action against the proposed federal rule from the Department of Health and Human Services that would bar any hospital accepting Medicaid funding from providing gender-affirming care to transgender youth. This rule represents an unprecedented federal overreach that threatens the lives of vulnerable young people in our community. The proposed rule weaponizes Medicaid participation requirements to create a de facto national ban on transgender youth healthcare. It goes far beyond restricting Medicaid reimbursement by threatening to strip Medicaid participation from any hospital that offers this care at all, regardless of payment source. This would effectively end access to medically necessary treatment for thousands of young people across the country, as virtually every major hospital system accepts Medicaid. The rule contains no exceptions for patients currently receiving care, meaning transgender youth in active treatment would have their care immediately terminated. This forced medical detransition could have devastating consequences, including increased rates of depression, anxiety, and suicidality among an already vulnerable population. This regulation violates Section 1801 of the Social Security Act, which explicitly prohibits the federal government from using Medicaid regulations to exercise direct supervision or control over the practice of medicine. It also tramples on states' rights under the Tenth Amendment by attempting to nullify democratically enacted state laws in California, Minnesota, New York, and other states that protect access to this care. As Khadijah M. Silver of Lawyers for Good Government stated, these draft rules are "a dangerous and unconstitutional attempt to undermine the longstanding right of states to ensure the health and well-being of their residents, the right of parents and caregivers to support and love trans and nonbinary young people, and the guidance of doctors and medical organizations on the well-established standard of care." I urge you to publicly oppose this rule, submit comments during the 60-day public comment period, and support any legislative efforts to block its implementation. Lives are at stake.