The massive budget cuts approved by the U.S. House of Representatives Thursday will disproportionately affect LGBTQ+ people. The budget bill still has to be approved by the Senate, where Democrats are hoping to change or block it. Here’s a look at the details.
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A last-minute addition to the bill bans federal funding for gender-affirming care for gender transition for both young people and adults. One provision of the measure strips all Medicaid and CHIP (the Children’s Health Insurance Program) funding for gender-affirming care, including puberty blockers, hormone therapy, and surgeries, not just for youth but for transgender people of any age. A second bans coverage for those same services under the Affordable Care Act by excluding them from the definition of “essential health benefits.”
It’s the first time Congress has voted to enact a nationwide ban on gender-affirming care.
Medical experts across the country — including every major professional association, from the American Academy of Pediatrics to the Endocrine Society — have affirmed that gender-affirming care is safe, evidence-based, and lifesaving. But the House GOP ignored that consensus in favor of legislation that LGBTQ+ advocates say weaponizes government power against trans lives.
“The House Republican budget bill passed this morning shows that anti-trans policies remain a top priority for both the party and the Trump administration,” said a statement from Imara Jones, founder of TransLash Media. “The fact that they are willing to ban federally funded health care for trans people of all ages — including adults on Medicaid and children enrolled in CHIP — shows that the goal all along has been to push trans people from public life.”
“Denying access to this care would not only worsen physical and mental health outcomes but would deepen housing insecurity, exacerbate mental health crises, and increase rates of depression and suicidality among trans people,” Sinead Murano-Kinney, health policy analyst at Advocates for Trans Equality, added in a statement. Similar to Jones’s comment, Murano-Kinney said, “This is no accident — it is part of a broader political agenda driven by anti-trans extremists determined to force trans, nonbinary, and intersex people out of public life.”
More cuts to Medicaid
The bill cuts spending overall for Medicaid, the joint federal-state program providing health insurance for low-income Americans.
“Estimates from the Congressional Budget Office find that the Republican proposals could kick 13.7 million people off of Medicaid,” the Human Rights Campaign notes in its analysis. “Medicaid is a crucial source of health care for LGBTQ+ individuals.” An estimated 22 percent to 25 percent of LGBTQ+ adults in the U.S. live in poverty, compared to about 16 percent of straight and cisgender adults.
The program covers a disproportionate share of low-income LGBTQ+ people, including 21 percent of trans people and 40 percent of people living with HIV. It’s the largest payer for HIV services in the nation. Also, many LGBTQ+ community health centers rely on federal funding through Medicaid to provide mental health services, gender-affirming care, and testing for sexually transmitted infections.
Slashing the Supplemental Nutritional Assistance Program
The cuts to the Supplemental Nutritional Assistance Program, a.k.a. SNAP, including stricter eligibility requirements, work mandates, and benefit reductions, would disproportionately impact LGBTQ+ people, especially those with disabilities or caregiving responsibilities, or those who are experiencing homelessness, according to the HRC.
LGBTQ+ Americans have higher rates of food insecurity than cis and straight ones. More than 27 percent of LGBTQ+ adults have struggled to afford food in the past year, HRC notes. Women, younger people, and LGBTQ+ people of color “are particularly vulnerable to food insecurity and would face heightened risks under a weakened SNAP program,” HRC’s analysis says.
Defunding Planned Parenthood
The bill would prohibit federal funding to Planned Parenthood, “targeting an organization that has worked diligently to create welcoming, affirming environments for the LGBTQ+ community and that is committed to reproductive freedom and providing care to all who need it,” HRC points out.
LGBTQ+ rights groups speak out
“People in this country want policies and solutions that make life better and expand access to the American Dream,” said a statement from HRC President Kelley Robinson. “Instead, anti-equality lawmakers voted to give handouts to billionaires built on the backs of hardworking people — with devastating consequences for the LGBTQ+ community. If the cuts to programs like Medicaid and SNAP or resources like Planned Parenthood clinics weren’t devastating enough, House Republicans added a last-minute provision that expands its attacks on access to best practice health care to transgender adults. This cruel addition shows their priorities have never been about lowering costs or expanding health care access — but in targeting people simply for who they are. These lawmakers have abandoned their constituents, and as they head back to their districts, know this: they will hear from us.”
Lambda Legal CEO Kevin Jennings issued a statement calling the budget “horrifically cruel and dangerous.” He added, “This unconscionable bill hollows out programs that serve the poorest and most vulnerable in our society, all to benefit the richest. It is estimated 13.7 million people will lose health coverage under this bill, and we know that will hit our community disproportionately, specifically including those living with HIV. This budget’s ‘bottom line’ will be increased deaths in LGBTQ+ and HIV+ communities, as well as for people living on limited incomes from all backgrounds. We call upon the U.S. Senate to reject this heartless attack on the LGBTQ+ community and everyone living with HIV. Lives literally hang in the balance.”