Overview

• The House approved the One Big Beautiful Bill Act with a last-minute amendment by a 215-214 vote that blocks Medicaid funding for gender transition procedures for both minors and adults.
• Nearly one in four transgender individuals in the U.S. rely on Medicaid for gender-affirming care, putting hundreds of thousands at risk if the Senate upholds the ban.
• Social conservative groups such as the American Principles Project lobbied House Republicans to insert the provision after sharing a poll showing 66% public support.
• Rep. Sarah McBride denounced the amendment as discriminatory and pledged to defend access to medically necessary care endorsed by leading health associations.
• The federal measure joins at least 27 state bans on youth gender-affirming treatments and faces legal challenges including the Supreme Court’s upcoming ruling in U.S. v. Skrmetti.