Don’t let employers voluntarily turn a new federal Medicaid regulation into a broader private insurance restriction.
If your family gets health insurance through your employer, now is the time to ask a simple question: Will you continue covering gender-affirming care?
This week, the federal government published a final CMS rule restricting federal Medicaid and CHIP funding for certain gender-affirming treatments for adolescents. The rule is scheduled to take effect October 13, 2026. Importantly, CMS says this action applies only to federal Medicaid and CHIP funding. It is not unusual for private insurers to choose to follow CMS regulations. (Learn more about the rule below)
That means employers have an opportunity, and a responsibility, to stand up for their employees and their families.
If your family receives health insurance through your job, contact your employer’s human resources or benefits department and ask them to commit to continuing coverage for gender-affirming care.
Step 1: Ask your employer to:
- Continue covering medically necessary gender-affirming care for employees and their dependents.
- Commit to maintaining that coverage in future plan years.
- Work with the plan administrator and insurance carrier to ensure transgender employees and dependents can access covered care without discriminatory exclusions or barriers.
- Tell employees clearly if changes to coverage are being considered.
Your employer has a choice. The federal government may be restricting one source of health care funding, but employers can choose to protect their employees and families rather than allowing political pressure to determine what health care their plans cover.
Take Action: Email your employer’s HR or benefits team today.
You don’t have to share your child’s name, diagnosis, or medical information. You can simply ask about the policy and make your position clear.
Copy and send:
Subject: Please Protect Gender-Affirming Health Care Coverage
Dear [HR/Benefits Team],
I am writing to ask that [Company] continue to provide comprehensive health insurance coverage for gender-affirming care for employees and their dependents.
The federal government has recently finalized a rule restricting federal Medicaid and CHIP funding for certain gender-affirming treatments for minors. This rule does not require private employer-sponsored health plans to eliminate this coverage.
I am asking [Company] to affirm its commitment to providing equitable health care coverage and to ensure that transgender employees and their families can continue to access medically necessary care through our health plan.
Please confirm whether [Company] intends to maintain that coverage in future plan years.
Thank you for standing with your employees and their families.
Sincerely,
[Name]
Step 2: Tell us what happened
We want to hear from families and employees who have contacted their employers. Knowing which employers are standing up and which are backing away will help us understand the landscape and identify opportunities for further advocacy. Report your response using this form.
What to know about the final CMS Rule:
CMS is prohibiting federal Medicaid and CHIP dollars from paying for what the administration calls “sex-rejecting procedures”—the federal government’s deliberately inflammatory term for gender-affirming medical care. The rule applies to adolescents only:
- Medicaid: people under 18
- CHIP: people under 19
It cuts off federal funding for puberty blockers, gender-affirming hormones, and related surgical procedures for transgender youth covered by these programs. States will be required to exclude these services from Medicaid and CHIP coverage for the affected age groups, meaning states will lose the federal matching funds they otherwise would have received for this care.
There is a six-month transition period.
The final rule includes one significant change from the proposal issued last year: young people who are already receiving covered hormone therapy can continue receiving federal funding for that medication for up to six months after the rule takes effect. That is intended to give patients and their clinicians time to develop a transition plan. It is not a substitute for continued access to care.
What the Rule Does Not Do
This distinction is critical: The rule does not make gender-affirming care illegal.
It does not prohibit a doctor from prescribing gender-affirming medication. It does not prohibit a hospital or clinic from providing the care. And it does not prevent private insurance from covering the care. Instead, it uses the federal government’s enormous financial power to make it substantially harder for transgender young people who rely on Medicaid and CHIP to access care. That is a deliberate policy choice. And it is one that will have real consequences for young people and families who already face significant barriers to accessing care.
What About Adults?
Adults are not affected by this particular rule. The rule applies to Medicaid beneficiaries under 18 and CHIP beneficiaries under 19. It does not eliminate federal Medicaid funding for gender-affirming care for adults.
What Happens Next?
The rule is scheduled to take effect 60 days after publication in the Federal Register, which puts the effective date in October 2026. We anticipate legal challenges. Those challenges could affect when the rule ultimately takes effect. We will be watching those cases closely and will continue to provide updates as they develop. But we also shouldn’t wait for the courts to act.