Medicaid Bans Funds for Kids' Sex-Rejecting Treatments Under 18
Published Date: 8/13/2026
Rule
Summary
This final rule requires that a State Medicaid plan must provide that the Medicaid agency will not make payment under the plan for sex-rejecting procedures for children under 18, and prohibits the use of Federal Medicaid dollars to fund sex-rejecting procedures for individuals under the age of 18. In addition, this final rule requires that a separate State Children's Health Insurance Program (CHIP) plan must provide that the CHIP agency will not make payment under the plan for sex-rejecting procedures for children under 19, and prohibits the use of Federal CHIP dollars to fund sex-rejecting procedures for individuals under the age of 19. For Medicaid and CHIP beneficiaries who are actively receiving cross-sex hormone therapy, State Medicaid and CHIP agencies may continue to claim Federal Financial Participation for those hormone therapy medications for a period of up to 6 months from the effective date of this final rule.
Analyzed Economic Effects
4 provisions identified: 1 benefits, 2 costs, 1 mixed.
Federal Medicaid funding banned for minors
If your child is covered by Medicaid, the State Medicaid plan must not make payments using Federal Medicaid dollars for sex-rejecting procedures for individuals under age 18. This prohibition takes effect October 13, 2026.
Federal CHIP funding banned for under-19s
For separate State CHIP plans, the CHIP agency must not make payments using Federal CHIP dollars for sex-rejecting procedures for individuals under age 19. This prohibition takes effect October 13, 2026.
6-month continuation for current hormones
If a Medicaid or CHIP beneficiary is actively receiving cross-sex hormone therapy on the effective date, State Medicaid and CHIP agencies may continue to claim Federal Financial Participation for those hormone medications for up to 6 months from October 13, 2026. After that 6-month period, Federal funding for those medications would no longer be allowed under this rule.
States and private insurers may still pay
This rule does not stop States from using State-only funds to cover sex-rejecting procedures, nor does it prevent coverage through other non-Federal funding such as private insurance. States may therefore choose to provide or fund these procedures outside of Federally-matched Medicaid or CHIP.
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Key Dates
Department and Agencies
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