The Massachusetts Senate is considering setting aside money as a backstop in case the Trump administration cuts public health insurance coverage of gender-affirming care for minors.
The Senate’s version of a spending bill, set for debate April 9, would put $3.5 million into the state’s Affirming Health Care Trust Fund. The sum would help preserve access to all gender-affirming care, with an eye towards specifically supporting transgender minors’ gender-affirming treatment — even if the federal government prevents Medicaid from covering that care.
Federal officials have argued that the restrictions on care for transgender minors are necessary to protect children’s health and safety. The Trump administration has repeatedly threatened to withhold any federal funding that helps minors seek gender-affirming care.
“We have heard so much concern and angst from trans young people and their families about the potential interference — and the very real risk, now,” said state Sen. Julian Cyr, a co-chair of the LGBTQ+ Legislative Caucus, who pushed for the funding in the Senate’s bill.
“We are going to be ready, and we’re going to ensure that we are going to protect some of our most vulnerable young people in Massachusetts,” he continued.
Transgender people, and particularly families with transgender kids, have been living in limbo since President Donald Trump took office.
The Trump administration issued a proposal in December that federal Medicaid dollars would no longer go toward gender-affirming medication for anyone ages 18 and younger. The final rule hasn’t been finalized yet. If it does take effect, private insurers are expected to continue covering transgender health care for minors under the state’s anti-discrimination laws.
At least three medical centers across the state have already stopped offering gender-affirming medications to minors, including Fenway Health in Boston and Baystate Health in Springfield. More clinics and hospitals could do the same in response to the flurry of actions top Trump officials have taken since the president’s inauguration — executive orders, investigations, subpoenas and proposed regulations that aim to limit transgender care for minors.
The Affirming Health Care Trust Fund was first established in last year’s budget cycle. It currently has $1 million that can be broadly used for care, supplies and services to treat transgender people’s gender dysphoria. Cyr said the new money is necessary as the Trump administration escalate its threats against gender-affirming care.
“We believe strongly that decisions about health care, and what health people are receiving: that should be up to their doctor. To patients. To their families,” he said. “This should not be something the government is trying to overreach or interfere in.”
It’s exceedingly rare for minors on MassHealth to take medications to affirm their genders.
According to state data obtained via a public records request, about 450 people ages 18 or younger with gender dysphoria had hormone replacement therapy covered by MassHealth last year. Another 98 took gonadotropin-releasing hormone agonists, more commonly known as “puberty blockers.” No bottom surgeries, vaginoplasties or phalloplasties, were performed on transgender minors.
Lawmakers in the House and Senate will hash out details of the spending bill in the weeks to come. The dollar amount could change in negotiations, or the proposal could be nixed altogether. House representatives focused on the issue say it’s a priority for both chambers.
This is a developing story.
