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The House voted 215–201 to pass the "Do No Harm in Medicaid Act," which would prohibit federal Medicaid funding for gender-transition surgeries and medications for minors.
This bill, known as the "Do No Harm in Medicaid Act," would stop the federal government from providing its share of funding to state Medicaid programs for specific medical procedures and medications intended for gender transition in individuals under 18. This includes surgeries such as mastectomies or reconstructive procedures, as well as medications like puberty blockers. The bill includes exceptions for treatments related to genetic disorders, early puberty, or complications from previous procedures. This was a vote on "passage," which is the final step for a bill to be approved by the House of Representatives. Because a majority of members voted in favor, the bill has officially passed this chamber and will now move to the Senate for consideration. In the House, a simple majority of those present and voting is required for a bill to pass. The outcome was almost entirely determined by party affiliation. Republicans voted unanimously in favor of the bill, while the vast majority of Democrats voted against it. The bill passed with a slim 6-vote margin, reflecting the deep ideological divide over federal funding for gender-affirming care for minors. The bill now heads to the Senate, where it faces a different set of political hurdles.
The bill has been received in the Senate and referred to the Committee on Finance for review.
OPEN BILL →Why it matters. This bill addresses the significant national debate over gender-affirming care for minors and the extent to which federal funds should support it. It represents a major policy shift that would prioritize biological sex definitions in federal healthcare funding.
Who’s affected. Minors on Medicaid: Would lose federal coverage for gender-transition medications and surgeries, potentially increasing out-of-pocket costs or limiting availability. · State Medicaid Agencies: Would no longer receive federal matching funds for these specific services, forcing states to either stop coverage or fund it entirely through state budgets. · Healthcare Providers: Clinics and hospitals providing these services would face reduced reimbursement revenue from the federal government.
Democrats. The Democratic caucus overwhelmingly opposed the measure, though four members broke ranks to vote with Republicans.
Republicans. The Republican caucus voted unanimously in favor of the bill among those present.
On Passage
Dec 18, 2025
The House voted 215–201 to pass the "Do No Harm in Medicaid Act," which would prohibit federal Medicaid funding for gender-transition surgeries and medications for minors.
A vote on passage is the final hurdle for a bill in the House of Representatives. Approval here means the House has finished its work on the legislation and is sending it to the Senate for a potential vote there.
The bill has been received in the Senate and referred to the Committee on Finance for review.
This bill addresses the significant national debate over gender-affirming care for minors and the extent to which federal funds should support it. It represents a major policy shift that would prioritize biological sex definitions in federal healthcare funding.
The vote followed a strict party-line pattern, with Republicans providing nearly all 'yes' votes and Democrats almost entirely in opposition.
The Democratic caucus overwhelmingly opposed the measure, though four members broke ranks to vote with Republicans.
The Republican caucus voted unanimously in favor of the bill among those present.
The single independent member joined the Republicans in voting 'yes'.