The Trump administration escalated its efforts this week to restrict transition-related medical care for transgender youth, taking a series of steps involving Medicaid funding, hospital billing practices and federal investigations.
The moves are also testing the limits of executive authority as the administration continues its push against gender-affirming treatments for children.
On Tuesday, the administration finalized a plan that would cut state Medicaid funding for hormone therapy, puberty blockers and surgeries provided to transgender youth.
According to the administration, 17 states currently provide some level of gender-affirming care for children through Medicaid and the Children’s Health Insurance Program, commonly known as CHIP.
Major medical organizations have pushed back against the administration’s actions, arguing that officials are misrepresenting the existing medical consensus surrounding such treatments.
The Department of Health and Human Services, however, said the new rule is intended to “help to protect these children.”
The administration followed that action with additional allegations Thursday involving the way hospitals bill insurers for gender-affirming treatments.
Federal officials alleged that hospitals have fraudulently billed insurance plans for such care in an effort to make money.
Vice President Vance cited a report commissioned by HHS while asking the Department of Justice to investigate the allegations.
“Some pediatric gender clinics and children’s hospitals have apparently used misleading or even fraudulent diagnostic and billing codes to ensure that insurance companies will cover the procedures,” Vance wrote in a letter to Attorney General Todd Blanche.
The report supports the administration’s argument that some children are being pushed toward gender-affirming treatments by adults motivated not only by what officials describe as “woke” ideology, but also by financial incentives.
The report was written by contributors from the fields of policy, medicine and media. Its authors either represent conservative and religious organizations that have criticized gender-affirming care or have previously advocated against the treatments themselves.
The Justice Department, meanwhile, has taken its own steps as part of the federal government’s scrutiny of providers.
DOJ has issued subpoenas to more than 20 hospitals, clinics and doctors across the country.
The subpoenas seek a broad range of information, including personnel files, patient records and communications between providers and pharmaceutical companies, among other materials.
One of those legal battles produced another victory for the administration Friday.
A federal appeals court upheld a Justice Department subpoena targeting QueerDoc, a telemedicine provider.
Taken together, the developments represent an expansion of the Trump administration’s efforts to limit transition-related medical treatment for transgender minors.
The administration is targeting multiple fronts simultaneously, from state Medicaid funding and insurance billing practices to hospitals, clinics, physicians and telemedicine providers.
While major medical groups dispute the administration’s characterization of gender-affirming care, federal officials maintain that their actions are aimed at protecting children and investigating potential misconduct surrounding how the treatments are provided and paid for.
