
June 17, 2025: The Senate’s proposed text for their version of H.R. 1 maintains the House bill’s provision blocking coverage for gender-affirming care for Medicaid and CHIP recipients of all ages. The Senate proposal does not contain the House’s provision allowing Affordable Care Act plans to stop covering gender-affirming care.
On May 22, 2025, the House of Representatives passed H.R. 1, the “One Big Beautiful Bill” Act. H.R. 1 contains provisions that endanger life-saving gender-affirming care for Medicaid enrollees and persons receiving care through Affordable Care Act (ACA) plans.
Since 2016, both Medicaid and ACA insurers have been prohibited from categorically excluding gender affirming surgery or hormone therapy from their coverage. H.R. 1 reverses these protections by specifically excluding coverage for gender-affirming care (including surgical and hormonal treatment) from Medicaid coverage. In addition, the bill removes gender-affirming care as an ‘Essential Health Benefit’ required to be provided by ACA policies. These changes in coverage are estimated to affect hundreds of thousands of transgender people throughout the US currently on Medicaid and ACA plans.
The research is clear: gender-affirming care saves lives. Demand your Senators strike this cruel and discriminatory provision in H.R. 1.
Hi, my name is [NAME] and I’m a constituent from [CITY, ZIP].
I’m calling to urge [REP/SEN NAME] to oppose H.R. 1, the budget reconciliation bill, and any discriminatory exclusions on gender-affirming care for transgender people. This bill will cause hundreds of thousands of transgender people on Medicaid, CHIP, and ACA policies to lose access to life-saving health care, and threatens the lives of transgender people across the country.
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