Reject Anti-Transgender Healthcare Riders in ACA Negotiations

I am writing to urge you to reject any provisions targeting transgender healthcare in upcoming negotiations over ACA subsidies and healthcare reform. Senate Republicans, led by Senators Mike Crapo and Bill Cassidy, recently unveiled a proposal that would bar Health Savings Accounts from treating gender-affirming care as medically necessary, prevent ACA plans from classifying it as an essential health benefit, and ban Medicaid from covering transgender healthcare entirely. Senate Majority Leader John Thune has endorsed this approach as the GOP's preferred response to rising premiums. While this specific proposal may lack a path to passage, it establishes transgender healthcare restrictions as a Republican negotiating position for future talks. This follows a pattern of similar attempts, including efforts to bar Medicaid coverage in budget reconciliation, anti-trans riders in shutdown funding bills, and provisions in the NDAA targeting Tricare coverage for gender-affirming surgeries. Healthcare coverage is essential for transgender people because transition-related care, lab work, and surgeries are financially prohibitive without insurance. Loss of coverage directly leads to increased suicidality and mental health crises. These are not abstract policy debates but matters of life and death for your constituents. Recent elections demonstrate that voters are exhausted by anti-trans messaging. Democrats like Abigail Spanberger in Virginia and Mikie Sherrill in New Jersey won decisively despite heavy Republican spending on anti-trans campaigns. Congressional Democrats have successfully blocked a national transgender sports ban and stripped healthcare bans from the NDAA, showing that principled opposition works. I ask that you continue this record of resistance by refusing to use transgender healthcare as a bargaining chip in any negotiations. Transgender people and LGBTQ communities represent a significant portion of the Democratic base and deserve unwavering support. Please stand firm against these discriminatory provisions and protect access to medically necessary care for all constituents.