The Centers for Medicare & Medicaid Services (CMS) is implementing an administration priority consistent with its commitment to protect children from experimental and life-altering sex-rejecting procedures that carry serious long-term health risks and lack sufficiently reliable evidence of clinical benefit. The final rule ends the use of federal Medicaid and CHIP funds to pay for these procedures on children and youth.
“Today, we are ending federal taxpayer funding for sex-rejecting procedures on children,” U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr, said. “These interventions carry serious risks and can cause irreversible harm. The federal government will no longer use Medicaid and CHIP dollars to fund procedures that fail to meet the evidentiary standard our children deserve.”
“Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits,” said CMS Administrator Dr. Mehmet Oz. “By cutting off federal funds for these sex-rejecting procedures, we’re following the science, saving taxpayer dollars, and, most importantly, protecting children from potentially irreversible harm so they can truly flourish.”
Sex-rejecting procedures on children, which include puberty blockers, cross-sex hormones, and surgical operations, can result in irreversible damage, including infertility, impaired sexual function, diminished bone density, altered brain development, and other lasting physiological effects.
CMS’ decision follows a review of national and international research by HHS that identified significant evidence gaps, documented serious safety concerns, and concluded that the evidence supporting these interventions for children remains insufficient to justify federal taxpayer funding. That reassessment is increasingly reflected within the medical community, as leading professional organizations — including specialty societies with direct expertise in this area, such as the American Society of Plastic Surgeons — clarify their positions on these interventions. CMS also points to international reviews, including the United Kingdom’s Cass Report, and actions taken by other countries and states here in the U.S. that have moved to restrict these procedures for minors.
Under the final rule, federal Medicaid and CHIP funding will be available for a tapering-off period of up to six months from the effective date of the final rule for children currently on hormone therapy. The rule does not affect coverage of mental health services. Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) provisions continue to ensure comprehensive coverage of mental health services for eligible children, and CHIP continues to require coverage of necessary mental health services in accordance with federal law.
This action applies only to federal Medicaid and CHIP funding.
Today’s action reflects CMS’ commitment to protecting children, safeguarding taxpayer resources, and ensuring that federal healthcare programs support treatments grounded in the best available evidence — not experimental interventions that carry potentially irreversible consequences for minors.
The final rule is scheduled to take effect October 13, 2026.
To view the final rule, visit: https://www.federalregister.gov/public-inspection/2026-16508/medicaid-program-prohibition-on-federal-medicaid-and-childrens-health-insurance-program-funding-for
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