Medicaid is a joint federal/state health insurance program that helps people with limited income cover the cost of healthcare. In January 2025, Rep. Dan Crenshaw (R-TX) introduced the Do No Harm in Medicaid Act (H.R. 498). This legislation amends the Social Security Act to stop Medicaid tax dollars from funding a specific list of gender transition procedures “performed for the purpose of intentionally changing the body of such individual (including by disrupting the body’s development, inhibiting its natural functions, or modifying its appearance) to no longer correspond to the individual’s sex.” * The bill still allows medically necessary care for minors—including care for precocious puberty, genetic disorders, or life threatening illnesses.** On December 15, 2025, this legislation passed the House by a vote of 215-201 and was sent to the Senate for consideration. The “Big Beautiful Bill” (signed into law on July 4, 2025) sought to address this topic, but that portion was stripped out. President Trump did sign Executive Order 14187 and there are other regulatory mechanisms that have been put in place to stop permanent gender-related treatment for minors. To date, however, Congress has not changed the statute. After being passed by the House, the H.R. 498 could be introduced in the Senate as companion legislation or potentially addressed in other legislative vehicles.

Sources:

*Text of H.R. 498: https://www.congress.gov/bill/119th-congress/house-bill/498#:~:text=This%20bill%20prohibits%20federal%20Medicaid,under%20the%20age%20of%2018.

**https://crenshaw.house.gov/2025/1/congressman-dan-crenshaw-introduces-do-no-harm-in-medicaid-act-to-protect-children-ensure-responsible-use-of-federal-funds