House · HR 498 · 119th Congress
Do No Harm in Medicaid Act
Sign in to cast a dissent vote.
Summary
This bill stops the federal government from paying for gender transition care for people under 18 through Medicaid. It covers surgeries, puberty-blocking drugs, and hormone treatments. Medical procedures for early puberty, genetic disorders, or life-threatening conditions are still allowed.
In Favor
Several European countries have restricted puberty blockers and cross-sex hormones for minors because long-term evidence is still unsettled. This bill stops federal Medicaid dollars from funding those same treatments, along with surgical procedures, until science better understands the risks to fertility and bone density. Supporters say taxpayers should not fund interventions with contested outcomes for children.
Against
This bill cuts off Medicaid coverage for gender care that some doctors say helps struggling youth. Low-income families who rely on Medicaid would lose access to treatments they cannot afford another way. Children in wealthier families would still be able to get the same care privately.
Additional Considerations
Purpose & Problem
Is the problem real and worth federal action?
The bill stops the federal government from paying its share of Medicaid costs for certain procedures performed on minors to change their bodies to differ from their biological sex. It targets a specific category of medical services for children under 18.
Scope & Related Provisions
Does it stay focused, or carry unrelated add-ons?
The bill stays focused on its core purpose. All its parts define which procedures are covered, list exceptions, and set terms. The provisions stay on topic.
Who Is Affected
Who benefits, and who bears the cost?
Minors enrolled in Medicaid who seek the listed procedures would lose federal funding for those services. States, Medicaid programs, and health care providers would face new rules about which services qualify for federal payment.
Cost & Funding
Is it affordable and responsibly funded?
The bill removes federal matching payments for the listed procedures and their program administration costs. No dollar amount or cost estimate appears in the sources. The bill reduces federal spending by cutting a category of covered services, but the sources name no specific figure.
Risks & Implementation
What could go wrong in practice?
States and providers must identify which procedures fall under the new definitions and which qualify for exceptions. The bill requires distinguishing between excluded and covered cases, which may create challenges for programs writing and following the new rules.
For the actual bill text, see congress.gov.
AI-generated · Published 6/5/2026