Trump Administration Finalizes Rule Ending Federal Medicaid and CHIP Funding for Gender Transition Procedures on Minors

The Centers for Medicare & Medicaid Services finalized a rule on Tuesday that prohibits the use of federal Medicaid and Children’s Health Insurance Program funds to pay for puberty blockers, cross-sex hormones, and surgical procedures intended to address gender dysphoria in children and youth.

The rule, announced by CMS under the direction of the Trump administration, takes effect on October 13, 2026. It ends federal taxpayer funding for what the agency describes as “sex-rejecting procedures” on minors, citing insufficient reliable evidence of clinical benefit and significant risks of irreversible harm. Health and Human Services Secretary Robert F. Kennedy Jr. stated that the government will no longer use Medicaid and CHIP dollars to fund interventions that fail to meet the evidentiary standard children deserve.

CMS Administrator Dr. Mehmet Oz said children deserve protection from experimental interventions that pose serious risks without proven benefits. The agency pointed to documented concerns including potential infertility, impaired sexual function, diminished bone density, altered brain development, and other lasting physiological effects. Officials also referenced international evidence reviews, such as the United Kingdom’s Cass Report, and decisions by other countries and numerous U.S. states that have restricted or ended these interventions for minors.

Under the final rule, federal funding will remain available for a limited tapering-off period of up to six months from the effective date for children already receiving hormone therapy. Mental health services related to gender dysphoria are not affected and may continue to receive federal support. States retain the option to cover the discontinued services using their own funds if they choose to do so.

President Donald Trump said he directed Oz to end the funding, describing the procedures as barbaric surgeries and practices that result in unthinkable and irreversible harm to young bodies. The rule applies to Medicaid coverage for those under 18 and CHIP coverage for those under 19.

The action builds on earlier administration efforts to align federal policy with evidence assessments that question the safety and efficacy of medical interventions for gender-dysphoric youth. Prior broader proposals that sought to condition broader hospital participation in federal programs on ending such care faced legal challenges and were adjusted. CMS projects modest savings from the policy while emphasizing that the primary goal is protecting children rather than budgetary considerations.Seventeen states had previously covered some form of these treatments under Medicaid or CHIP. The rule does not ban the procedures in states where they remain legal but removes the federal matching funds that have supported them for low-income families. Implementation will proceed as scheduled unless altered by further legal action.