CMS Final Rule

The U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services, issued a final rule ending the use of federal Medicaid and children’s-insurance (CHIP) funds to pay for sex-rejecting procedures on children and youth. HHS describes those procedures as including puberty blockers, hormones of the opposite sex, and surgical operations.

• The rule prohibits federal Medicaid dollars for sex-rejecting procedures for people under 18, and federal children’s-insurance (CHIP) dollars for people under 19 (CMS-2451-F).
• HHS says the final rule is scheduled to take effect October 13, 2026.
• Federal Medicaid and CHIP funding will be available for a tapering-off period of up to six months from the effective date for children currently on hormone therapy.
• The rule does not affect coverage of mental health services. HHS states this action applies only to federal Medicaid and CHIP funding.
• CMS says the decision follows HHS’s review of national and international research, including the United Kingdom’s Cass Report, that found significant evidence gaps and serious safety concerns.