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CIVIC HERALD
HR 498 · 119th Congress · HouseIn committee

Do No Harm in Medicaid Act

In plain language: This bill prohibits federal Medicaid funds from covering gender transition medical care for minors under the age of 18. The funding ban applies to puberty-blocking medications, cross-sex hormones, and transition-related surgeries, as well as state administrative costs for managing these services. Federal matching funds remain permitted with parental consent for treating precocious puberty, diagnosed genetic disorders of sex development, or life-threatening physical complications resulting from prior procedures.

Provisional: our plain-language summary, pending review.

Provisionalunreviewed: impact, issue tags, provisions, stakeholders, summary
People affectedNot determinable from the text provided; the bill affects Medicaid-enrolled minors seeking gender transition procedures and state Medicaid agencies, but provides no demographic counts.
Fiscal magnitudeno CBO estimate published
Reach52provisional · pending reviewrigor: heuristic llm
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Issues

What this bill touches.

LGBTQ+ policy−55Government role in coverage−30Federal vs. state/local+25

The sign shows the bill's direction on each issue (+ toward, − away); the number is its magnitude. Color never encodes good or bad, and never party.

Who it affects

Who it helps · who it burdens.

Who it burdens

  • State Medicaid agenciesProhibits federal Medicaid payments to states for specified gender transition procedures for enrollees under 18 years of age, as well as federal matching for state administrative expenses for programs furnishing these services (Sec. 2(a)).provisional
  • Medicaid-enrolled minors seeking gender transition proceduresLoses federal Medicaid funding and coverage for puberty-blocking drugs, cross-sex hormone therapy, and surgical transition procedures (Sec. 2(a), Sec. 2(b)(A)).provisional
  • Medicaid healthcare providersProhibits federal Medicaid reimbursement for performing gender transition surgeries or prescribing transition-related puberty blockers and hormones to patients under 18 years of age (Sec. 2(a), Sec. 2(b)(A)).provisional

Dollar-level funding (FEC sector totals) is coming in a later phase.

What it does

The provisions, in plain language.

  1. Prohibits federal Medicaid payments to states for gender transition procedures provided to individuals under 18 years of age, including puberty-blocking drugs, cross-sex hormone therapy, transition-related surgeries, and state administrative costs for these services.

    Sec. 2(a)provisional
  2. Allows Medicaid funding with parental or guardian consent for puberty blockers to treat precocious puberty, treatments for medically verifiable genetic disorders of sex development, care for life-threatening physical injuries or illnesses, and procedures to reverse prior transition treatments.

    Sec. 2(b)(B)provisional

How your members of Congress line up

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Timeline

How it moved.

  1. Dec 18, 2025Received in the Senate and Read twice and referred to the Committee on Finance.
  2. Dec 18, 2025Motion to reconsider laid on the table Agreed to without objection.
  3. Dec 18, 2025On passage Passed by the Yeas and Nays: 215 - 201 (Roll no. 362). (text: CR H6057)
  4. Dec 18, 2025Passed/agreed to in House: On passage Passed by the Yeas and Nays: 215 - 201 (Roll no. 362).
  5. Dec 18, 2025On motion to recommit Failed by the Yeas and Nays: 204 - 212 (Roll no. 361).
  6. Dec 17, 2025Rules Committee Resolution H. Res. 953 Reported to House. Rule provides for consideration of H.R. 6703, H.R. 498 and H.R. 3492. The resolution provides for consideration of H.R. 6703 and H.R. 498 under a closed rule and H.R. 3492 under a structured rule with one hour of general debate and one motion to recommit on each bill.
  7. Jan 16, 2025Introduced in House
  8. Jan 16, 2025Introduced in House

The original text

Read it for yourself.

Sources & provenance

Congress.govrefreshed 17 days ago

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