Federal funding cut for gender transition care; costs shift to individuals

What it does

This bill denies federal tax deductions and federal funding (Medicaid, CHIP, Medicare) for gender transition procedures, defined as hormonal or surgical interventions intended to align physical appearance with a gender identity different from biological sex. It also excludes such procedures from essential health benefits under the Affordable Care Act. The bill carves out exceptions for intersex conditions, treatment of complications, and procedures for precocious puberty. Citizens who pursue gender transition care would lose tax deductions for medical expenses and federal insurance coverage, shifting costs to individuals and state budgets.

Why we flagged it

The bill's operative mechanism is to deny federal tax deductions and federal insurance reimbursement for a specific category of medical procedures. It is not a tax cut, subsidy, or carve-out for a private party; it is a restriction on federal support for a medical service.

What the text implies

• The bill's definition of 'sex' as 'biologically determined' at conception may create legal ambiguity in cases of intersex individuals or those with disorders of sex development, potentially affecting coverage of legitimate medical care for these populations despite stated exclusions.
• Exclusion from ACA essential health benefits may allow insurers to drop coverage entirely, even for individuals in states that do not follow the federal restriction, creating a patchwork of coverage availability.
• The restriction applies to all ages, including adults, not just minors, despite framing that often emphasizes pediatric concerns.
• State Medicaid programs retain authority to fund these procedures with state-only dollars, but the federal funding restriction may create political pressure on states to defund them entirely.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Citizens seeking gender transition care lose federal tax deductions and federal insurance coverage, increasing out-of-pocket costs and reducing access to care for lower-income individuals and those on federal insurance programs. The bill does not create a public benefit; it restricts existing federal support for a category of medical care.

Named in the bill

Internal Revenue Service, Centers for Medicare & Medicaid Services, Medicaid, Medicare, Children's Health Insurance Program (CHIP), Patient Protection and Affordable Care Act, Department of Health and Human Services

Where it stands

3 cosponsors: 3 Republicans.

• May 5, 2025 — Introduced · Congress.gov: “Introduced in House”
• May 5, 2025 — Referred to House Committee on Ways and Means and House Committee on Energy and Commerce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

1 lobbying clients named this bill on 2 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $439,908 in lobbying spend. A filing names 132 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 0% of bills with at least one filing.

Claudia Tenney, the sponsor, reported $1,189,908 in PAC receipts in the 2026 cycle.

• Human Rights Campaign — $439,908 on 2 filings

Lobbying Disclosure Act filings through Jul 17, 2026. A filing shows who paid to lobby on a bill it names, not what changed.