H.R. 498 · Where this bill is now
In the Senate
Passed the House Dec 18, 2025. Received Dec 18, 2025; no Senate vote yet
What this bill does
In plain words · AI-written from the official summaryLimits Medicaid coverage for youth gender transition
This bill would prohibit federal Medicaid funding for gender transition procedures—including surgeries, implants, and medications like hormones—for people under 18. It does carve out exceptions: procedures that treat early puberty, genetic disorders, chromosomal abnormalities, reverse prior transition procedures, or prevent serious harm would still be covered with parental consent.
How it affects you
If you're under 18 and covered by Medicaid, you would lose federal funding for certain gender transition procedures, though your state's Medicaid program might cover them with state funds. Young people facing medical exceptions listed in the bill would still have coverage access. Families on Medicaid caring for youth would see changes in what their insurance covers.
Read the official summary (Introduced in House, Jan 16, 2025)
Do No Harm in Medicaid Act
This bill prohibits federal Medicaid payment for specified gender transition procedures for individuals under the age of 18. The bill defines these procedures to mean those that are intended to change the body of an individual to no longer correspond to the individual's biological sex (male or female), including specified surgeries, implants, and medications (e.g., hormones).
The bill excludes procedures that are provided to an individual under the age of 18 with the consent of a parent or legal guardian and that are intended to (1) rectify early puberty, genetic disorders, or chromosomal abnormalities; (2) reverse prior gender transition procedures; or (3) prevent imminent death or impairment of a major bodily function.
Written by AI (Claude) using only the official summary by the Congressional Research Service, the Library of Congress’s nonpartisan research staff. It can miss nuance, so check the official summary and the bill text for details.
1st SessionH. R. 498
AN ACT
Do No Harm in Medicaid Act
Sponsor: Rep. Dan Crenshaw (R-TX-2) · Introduced Jan 16, 2025 · Health · 3 versions of the text
Sources: Congress.gov actions and votes · bill text from GovInfo · latest official action Dec 18, 2025: “Received in the Senate and Read twice and referred to the Committee on Finance.”
How Congress voted
Official roll callsHouse · On Passage · Dec 18, 2025
Passage Passed 215–201
| Party | Yes | No | Didn’t vote |
|---|---|---|---|
| Democrats | 4 | 201 | 8 |
| Republicans | 211 | 0 | 9 |
4 members voted against most of their party: 4 Democrats voted Yes.
Congress votes on whole bills and amendments, not on single sections.
Sections
The wording of this bill hasn’t changed across its 3 official versions.