In a rare moment of relief for the transgender community, a controversial provision that would have banned Medicaid coverage for gender-affirming care was dropped from the final version of former President Donald Trump’s “Big Beautiful Bill,” which he signed into law on July 4.
The massive spending package, officially the Taxpayer Restoration and Budget Responsibility Act, includes sweeping changes to federal programs, but transgender Americans avoided one of the most alarming attacks buried in earlier drafts: a nationwide prohibition on using Medicaid and CHIP funds for gender transition care. The anti-trans provision, championed by Rep. Marjorie Taylor Greene and other far-right lawmakers, was stripped during negotiations in the Senate after a wave of public backlash and internal Republican debate.
For many transgender people and advocacy organizations, the removal of the Medicaid ban is a hard-won, if precarious, victory.
Liana Cortez, a policy analyst with Trans Health Equity Alliance, expressed relief after feeling oppressed for weeks. “Our community mobilized, made noise, and made clear that stripping access to care for low-income trans people is not just cruel, it’s deadly.”
The removed provision would have denied healthcare access to some of the most vulnerable transgender individuals: those who rely on federal insurance to survive. Gender-affirming care, including hormone therapy, puberty blockers, and related mental health services, is considered medically necessary by major medical organizations, including the American Medical Association and the American Psychiatric Association.
Despite the defeat of the provision, the LGBTQ+ community has not embraced the bill itself. Many advocates remain wary of the broader spending law, which cuts deeply into social safety nets and redirects funding to programs that may leave marginalized populations behind.
“We’re glad that trans care survived this round,” said Cortez. “But make no mistake: this bill still reflects a political agenda that views our existence as a bargaining chip.”
Republicans, meanwhile, celebrated the bill’s passage as a major policy win. Trump held a signing ceremony on Independence Day, calling the legislation “the greatest tax and spending reform in American history.” While he did not mention the removal of the Medicaid ban directly, several right-wing lawmakers voiced disappointment over its exclusion.
“We had an opportunity to take a stand against the medical abuse of children,” said Greene in a Truth Social post, accusing moderate Republicans of “betraying the conservative base.”
Advocates worry that the fight is far from over. While this particular attempt to block Medicaid-funded care failed, similar efforts continue at the state level. Just last month, several states introduced bills aiming to ban insurance coverage for transgender healthcare, and court battles remain ongoing over existing restrictions.
For now, transgender Americans who rely on Medicaid can breathe a little easier, but few are letting their guard down.
“We’ve seen how quickly our rights can be stripped away,” said Cortez. “We’re not celebrating the absence of cruelty; we’re preparing for the next round. But today, we exhale.”
The fragility of this win is not lost on the community. It’s a reminder that while visibility is growing, so is the opposition. And in that space between the two, the lives of transgender individuals continue to hang in the balance.
