For trans people on Medicaid, Trump’s “Big, Beautiful Bill” is anything but

[Jessica_Rose]

For trans people on Medicaid, Trump's "Big, Beautiful Bill" is anything but

https://www.lgbtqnation.com/2025/06/for-trans-people-on-medicaid-trumps-big-beautiful-bill-is-anything-but/

Henry Carnell (3 June 2025)

Last week, Max, a trans man in North Carolina in his twenties—and my childhood friend—got top surgery.

Three days after Max's surgery, Donald Trump's "Big, Beautiful Bill," a massive package of GOP tax and spending legislation, passed the House with a last-minute amendment that would ban Medicaid and Affordable Care Act marketplace plans from covering transgender health care like Max's surgery and hormone replacement therapy. Approximately 185,000 trans adults, or about one in twelve in the US, are on Medicaid, according to the University of California, Los Angeles' Williams Institute.

Max could only afford his surgery because it was covered in part by Medicaid. Medicaid also provided his hormone replacement therapy—prohibitively expensive without insurance—and the rest of his health coverage for the last several years, while he's juggled school with full-time work.

The "Big, Beautiful Bill" has yet to pass in the Senate, and Democratic senators are working to use the Byrd Rule, which limits "extraneous" provisions to the budget, to remove its amendment against gender-affirming care.

If the bill passes with that amendment intact, said Jennifer C. Pizer, chief legal officer at LGBTQ civil rights nonprofit Lambda Legal, "There will be litigation, because the harms are quite serious and it legitimizes the range of other cruel and unjustifiable treatments of transgender people."