All Roll Calls
Yes: 419 • No: 413
HR498119th CongressWALLET
Do No Harm in Medicaid Act
Sponsored By: Representative Crenshaw
Passed House
Summary
Prohibits Federal Medicaid funding for most gender-transition procedures for individuals under 18. This change amends Title XIX of the Social Security Act to list the specific surgeries, implants, and drugs that Medicaid cannot fund for minors and it outlines narrow medical exceptions.
Show full summary
- Families and minors: Minors enrolled in Medicaid will not have federal reimbursement for a long list of gender-transition surgeries, chest or genital implants, fat or gluteal implants, puberty blockers, or cross-sex hormones when given to anyone under 18.
- States and providers: States and Medicaid providers cannot claim Federal matching funds for those specified procedures or for administering state programs or waivers that furnish them to under-18 enrollees.
- Medical exceptions and definitions: Parental or guardian consent allows limited exceptions such as puberty suppression for precocious puberty and treatments for medically verifiable disorders of sex development, chromosomal or hormone abnormalities, serious injury or disease, or reconstruction after prior procedures. The law also defines “sex” as biologically male or female and lists exact procedures and drug types covered by the prohibition.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 1 costs, 0 mixed.
No Medicaid funding for minors' gender care
If enacted, Federal Medicaid dollars would not pay for gender transition care for anyone under 18. This would apply to state plans and waivers, and to related program administrative costs. It covers surgeries and implants, plus puberty blockers and high-dose sex hormones when used for gender transition. Exceptions would be narrow: treating precocious puberty, certain medical disorders, repairs, emergencies, or restoring the body. A doctor and a parent or guardian would need to consent, and mental distress alone would not qualify. The bill defines sex as male or female for this rule and would take effect upon enactment.
Sponsors & CoSponsors
Sponsor
Crenshaw
TX • R
Cosponsors
Greene (GA)
GA • R
Sponsored 1/16/2025
Weber (TX)
TX • R
Sponsored 2/13/2025
Steube
FL • R
Sponsored 9/2/2025
Davidson
OH • R
Sponsored 12/16/2025
Grothman
WI • R
Sponsored 12/18/2025
Luna
FL • R
Sponsored 1/21/2026
Roll Call Votes
house vote • 12/18/2025
On Passage
Yes: 215 • No: 201
house vote • 12/18/2025
On Motion to Recommit
Yes: 204 • No: 212
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