The Trump administration plans to stop funding trans youth on Medi-Cal. What it means for families

The Trump administration has finalized a federal rule that outlaws the use of Medi-Cal funds for gender-affirming hormones and surgeries for youth — though a one-time fund California lawmakers approved this year could help fill that gap.

Providers have been bracing for this rule to take effect since last year.

If it is not blocked, it would mean:

• No Children's Health Insurance Program (CHIP) funds for people under 19 seeking gender-affirming hormones and surgeries
• No Medicaid funds for people under 18 seeking gender-affirming hormones and surgeries

The rule does not affect Medi-Cal funding for mental health services for trans youth.

Steps California has taken

In anticipation of these cuts, the state has already approved:

• $26 million in one-time funding specifically to support providers of trans healthcare
• A $30 million general fund for healthcare that isn’t covered by Medi-Cal reimbursements.

“These historic investments, approved by Governor Newsom in June, ensure California has state resources available to protect access to gender affirming medical care as federal Medicaid and CHIP funding is withdrawn,” Joe Hollendoner, who lobbied the state for these funds as Los Angeles LGBT Center’s CEO, said in a statement.

Another federal rule appears sidelined

A separate rule introduced by the U.S. Department of Health and Human Services would ban any hospital that receives Medicare or Medicaid funding from providing trans youth with hormones or surgeries, which the department referred to as "sex-rejecting procedures." As of last month, that rule appears to have been sidelined and has not been finalized.

Reaction to the federal moves

Healthcare advocates for trans youth in California have condemned the finalized rule and other efforts to curtail access to gender-affirming care. At the same time, they emphasize that trans healthcare for youth is still legal.

“This rule ignores the science and puts politics between transgender young people, their families, and the medical professionals who know them and care for them,” said Kathie Moehlig, the executive director of the organization TransFamily Support Services, in a statement. “Families should not have to live in fear that their child’s healthcare can be taken away because of who they are.”

The California LGBTQ Health and Human Services Network said in a statement that if the rules take effect, it anticipates “providers may face increased uncertainty and fear about whether they can continue providing services, while families will be left navigating new barriers to care as they strive to support their child.”

What's next

Civil rights lawyers for the American Civil Liberties Union, Lambda Legal and other groups have been saying for months that they will challenge the federal rule on Medi-Cal funding. During the public comment period, which ended in February, a vast majority of the people who gave feedback on the newly finalized rule opposed it.

Ariela Cuellar, a spokesperson for the California LGBTQ Health and Human Services Network, called the rule change “a wake up call for states to take aggressive actions to protect essential medical care and push back on this unprecedented federal overreach.”

Though the rule has been finalized, it won’t go into effect immediately. If it’s not blocked by a judge, the rule will take effect Oct. 13.