News summary produced by Claude AI
The Trump administration has moved away from finalizing a proposed rule that would have eliminated all Medicare and Medicaid funding to hospitals offering gender-affirming care to minors, according to documents obtained by NPR. The Department of Health and Human Services appears unlikely to complete the rulemaking process, with the rule not advancing to the Office of Management and Budget for final review stages.
When proposed in December, the rule generated more than 30,000 public comments. Instead of proceeding through the typical finalization process, the administration has assigned the rule a final action date of December 2028 and classified it under “Long-Term Actions” in its unified agenda. The rule has not been formally withdrawn, leaving its status uncertain. An HHS spokesperson initially stated the department had not reversed course, claiming it would continue reviewing comments with intent to issue a final rule, though this has not occurred.
Legal experts note that keeping the rule in limbo serves the administration’s goals by maintaining pressure on healthcare providers even without finalization. The proposed rule would have been unprecedented in using Medicare and Medicaid funding conditions to prohibit specific treatments for a particular population, rather than enforcing health and safety standards as historically practiced. Legal scholars have questioned whether such an approach would violate the Medicare Act, which restricts HHS from controlling medical practice within states.
Meanwhile, the Trump administration is advancing other measures targeting gender-affirming care. A separate Medicaid rule barring federal reimbursement for transgender pediatric patients is in final review stages, and the Department of Justice has issued subpoenas to hospitals for medical records of transgender youth and employment files of their providers. Gender-affirming care is already banned in 27 states. Hospital clinics in remaining states have continued operating in some areas while closing in others, citing pressure from federal actions.
Observers indicate this particular decision not to finalize the rule is significant, as finalized rules carry more legal durability than proposed rules kept in limbo. Some policy experts view the administration’s pullback on this specific measure as potentially giving hospitals confidence to continue offering care, while noting the broader administration agenda remains focused on restricting healthcare access for transgender individuals through various mechanisms.