The Trump administration has reaffirmed its pursuit of a sweeping Medicare funding block on providers of pediatric gender-affirming care in response to a report that it planned to abandon the attempt, which has faced hurdles in court.
The Department of Health and Human Services (HHS) and its Centers for Medicare and Medicaid Services (CMS), in December, unveiled a proposed rule that would add a ban on some of these services for minors—specifically, those involving pharmaceutical or surgical interventions—as a condition of participation in Medicare and Medicaid programs. Nearly all of the country’s hospitals participate in the government programs, and rely on them as a substantial portion of their revenue.
The proposed rule was challenged by 21 state attorneys general who argued that the policy change would supersede their ability to regulate providers, and in the subsequent months secured an order from an Oregon federal judge enjoining CMS from implementing its proposal.
The Office of Management and Budget’s website shows that the final version of that proposal has been under review by the agency since June 16. And the administration, as recently as late June, has petitioned the court to amend its judgment.
On Monday, however, NPR reported that it had obtained “an official document” indicating that HHS no longer planned to finalize the proposed rule (though it also had not formally withdrawn the proposal).
While the NPR report cited an on-the-record statement from CMS declining to comment on future rulemaking, HHS took a more concrete stance late Tuesday morning by describing the report’s claims as “completely inaccurate and unfounded.”
“The Department has not withdrawn or reversed course on the [proposed gender-affirming care] rule,” an HHS social media account wrote on X. “HHS and CMS continue to follow statutory requirements by reviewing comments, and we intend to issue a final rule. HHS remains committed to protecting children from potentially lifelong, irreversible, and harmful sex‑rejecting interventions.”
In line with an executive order from the president early in his second term, HHS spent much of last year laying the groundwork for its proposed rule with information requests, warning notices and a literature review in which authors concluded there was limited known benefit but substantial risks involved with pediatric gender-affirming care. Most medical professional groups largely disagree with that stance, including the American Academy of Pediatrics, the American Medical Association and the American Psychological Association.
The scrutiny has led to at least dozens of hospitals and other pediatric providers suspending or shuttering their gender-affirming care programs. Others, who were subject to False Claims Act investigations by other wings of the executive branch, have signed commitments with the government to halt the services and devote funds toward those seeking to reverse their prior procedures.
Several judges have pushed back on law enforcement’s efforts to subpoena records from hospitals regarding previously delivered services and patients. The Federal Trade Commission also recently sued a prominent nonprofit gender dysphoria professional organization, the World Professional Association for Transgender Health (WPATH), over allegedly mischaracterizing medical evidence that support its guidelines for pediatric gender-affirming care, an effort that already scored an early courtroom win over WPATH’s motion to dismiss.