Health policy expert to RFK Jr.: You can't ban trans youth care this wayhttps://www.advocate.com/politics/hhs-gender-affirming-care-restrictions 🔗Christopher Wiggins (18 Dec 2025)
Over the last 24 hours, the Trump administration has marshaled extraordinary federal power to restrict health care for transgender youth, a population that makes up well under 1 percent of Americans, while leaving untouched a looming crisis that threatens millions more: the scheduled January expiration of Affordable Care Act tax credits that keep health insurance affordable on the Obamacare exchanges.
Late Wednesday, the House passed the most extreme anti-transgender health care bill ever to clear Congress, legislation sponsored by Republican Rep. Marjorie Taylor Greene of Georgia that would criminalize parents and doctors for providing best-practice medical care to transgender young people.
If finalized, the proposals would bar hospitals that provide gender-affirming care to minors from participating in Medicare and Medicaid, prohibit federal Medicaid and Children's Health Insurance Program funds from covering such care nationwide, and roll back transgender-inclusive civil rights protections by excluding gender dysphoria from Section 504 of the Rehabilitation Act.
Health policy experts say the administration is asserting authority it does not have.
"They are trying to do something that CMS simply isn't empowered to do," a former senior Centers for Medicare & Medicaid Services official from the Biden administration told The Advocate on Thursday afternoon. "CMS is prohibited by statute from regulating the practice of medicine, and that is exactly what this is. The authority that they are citing for these actions does not exist."
The former official said CMS has historically deferred to states to define what constitutes medically necessary care and has never used its Medicaid authority to prohibit an entire category of treatment nationwide. "They are trying to transform CMS into a medical board," the official said. "This is unprecedented, and they know it."
