Dan Crenshaw // Wikimedia Commosn // Gage Skidmore
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After news broke that Rep. Marjorie Taylor Greene’s bill banning gender-affirming care for transgender youth nationwide would receive a full vote in Congress on Dec. 17, another anti-transgender bill was scheduled for the same day. That measure, introduced by Rep. Dan Crenshaw of Texas, would ban Medicaid from covering gender-affirming care for transgender youth. Taken together, the two bills mark a significant escalation in Republican attacks on transgender people. For the first time, Congress is preparing to openly debate and vote on national bans targeting transgender youth health care—placing itself squarely in the same posture as many Republican-controlled states over the past several years, where legislative floor time has increasingly been consumed by efforts to single out transgender people for restriction and punishment.
Crenshaw’s bill, titled the “Do No Harm in Medicaid Act,” appears designed to function as a more “palatable” alternative to Marjorie Taylor Greene’s sweeping national ban on transgender health care. Rather than criminalizing providers outright, the bill focuses on Medicaid, barring all Medicaid coverage of gender-affirming care for transgender youth. The narrower framing is likely intentional: an effort to unify Republicans around a single restriction on trans youth care, while also creating a measure that could tempt Democrats who are being urged by certain political consulting groups to give ground on transgender people. Until recently, only a small handful of Democrats had broken rank on votes targeting transgender rights. That number has begun to creep upward, however, following a transgender sports ban vote earlier this year—making bills like Crenshaw’s especially important markers of where members ultimately draw their lines.
The bill relies on standardized language that has appeared in many other anti-transgender health care bans and likely draws from the same model legislation promoted by far-right groups such as the Alliance Defending Freedom and the Family Policy Alliance. It applies broadly, covering puberty blockers, hormone therapy, and surgical care for anyone under the age of 18, while explicitly allowing cisgender people to receive the same medications for other medical purposes while denying them to transgender youth. The bill also includes a definition of sex that Republicans have increasingly attempted to insert into legislation touching gender issues, defining female based on reproductive capacity as someone who “has, had, will have, or would have, but for a developmental or genetic anomaly or historical accident, the reproductive system that at some point produces, transports, and utilizes eggs for fertilization.”
This is not the first time Republicans have attempted to target Medicaid coverage for transgender people. Earlier this year, a similar provision banning Medicaid coverage for transgender people of all ages was stripped from Trump’s sweeping tax and spending bill after Democrats fought to have it removed. Likewise, during the recent budget fight, the House Labor, Health and Human Services, and Education package included multiple anti-transgender provisions, including a total federal funding ban that could devastate transgender health care nationwide. Republicans have also attempted to attach anti-trans health care restrictions to other major legislation, including during recent votes over ACA subsidies, where caucus-backed proposals like the Crapo-Cassidy bill pushed similar policies before ultimately failing. Now, it appears Republicans are advancing this proposal as a standalone bill, an effort to force members of Congress on the record about their position on banning health care for transgender youth.
When asked about the bills, Democratic Representative from Delaware Sarah McBride told Erin In The Morning, “Once again, Republicans in Congress are prioritizing attacks on trans people and their families over addressing the cost of health care, housing, or energy. When it comes to health care decisions, government has no place inserting itself between patients, providers, and parents to prevent health care that has been deemed necessary. A person being transgender doesn’t change that basic principle. Republican politicians are obsessed with trans people, and as this week demonstrates, they are extreme, scheduling a bill that could imprison parents and health care professionals for affirming their trans child. I continue to engage with colleagues to guarantee that they understand the seriousness of these bills and the harm they could inflict on their own constituents.”
The bill is slated to be heard on the same day as Marjorie Taylor Greene’s “Protect Children’s Innocence Act,” which Greene announced would receive a House floor vote after she traded her vote on the NDAA for a commitment from congressional leadership. Greene’s bill would enact a nationwide felony ban on gender-affirming care for transgender youth, explicitly defining such care as “mutilation.” Neither bill is expected to advance in the Senate, but both are likely to function as important messaging votes, forcing members of Congress on both sides of the aisle to publicly stake out their positions on one of the most contentious transgender-related issues now before lawmakers. Previously, a handful of House Democrats have shown support for other anti-LGBTQ+ provisions primarily centering on transgender people: Henry Cuellar (TX), Donald G. Davis (NC), Cleo Fields (LA), Shomari Figures (AL), Laura Gillen (NY), Jared F. Golden (ME), Vicente Gonzalez (TX), Adam Gray (CA), Susie Lee (NV), John W. Mannion (NY), Marie Gluesenkamp Perez (WA), Kim Schrier (WA), and Thomas R. Suozzi (NY).
You can contact your representative and encourage them to vote against the bill here.
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