The U.S. House of Representatives has passed a sweeping and controversial bill that could dramatically reshape American health care—and directly target the transgender community. After more than 24 hours of debate, the bill passed by a razor-thin margin of 215 to 214. Nicknamed the “Big Beautiful Bill” by its supporters, the legislation is expected to add $2.4 trillion to the national debt by increasing spending and cutting taxes.
But much of its financing will come from deep cuts to federal health programs, including a full ban on gender-affirming care for transgender people under Obamacare, Medicaid, and CHIP. This amendment removed the word “minors,” extending the ban to all transgender Americans. Under the bill, no Medicaid or CHIP funds can be used for gender-affirming care, such as puberty blockers, hormone therapy, or surgery, for anyone, regardless of age. And insurance plans sold on the Affordable Care Act exchanges, as well as those tied to the same coverage standards, will also be prohibited from covering gender transition procedures.
This could be devastating for the estimated 152,000 transgender people who rely on Medicaid, particularly since fewer than half live in states that provide gender-affirming coverage. Mark Takano, an out gay Democrat from California, reacted to this bill, saying, “But that doesn’t matter to Republicans in Congress—they need those cuts to pay for their billionaire buddies’ tax cuts.
Attacks on the trans community are just the cherry on top for them.” The bill also slashes $500 billion from Medicare and removes Medicaid coverage for 8.7 million Americans. Democrats have unanimously opposed the legislation, joined by just two Republicans. The bill now heads to the Senate, where Republicans plan to use the reconciliation process to bypass a filibuster. With 53 Republican senators, its passage remains highly possible. And if it reaches the president’s desk, he is expected to sign it.
